腓肠神经营养血管皮瓣与足底内侧皮瓣治疗足跟部皮肤软组织缺损效果比较

目的通过对腓肠神经营养血管皮瓣与足内侧皮瓣治疗足跟部皮肤软组织缺损的效果比较，进一步研究腓肠神经营养血管皮瓣具体的临床效果，为该皮瓣在，临床上的应用提供理论依据。方法对不同类型的足跟部软组织损伤，23例采用足底内侧皮瓣修复，19例采用腓肠神经营养血管皮瓣修复，术后通过对两组皮瓣修复面积、皮瓣长、宽及Fugl—Meyer下肢运动功能评定量表、Enneking下肢功能评分系统、改良Barthel指数评定量表对治疗效果进行评价，采用SPSS13．0软件，利用两样本t检验进行统计学分析。结果在修复创面大小上，腓肠神经营养血管皮瓣组修复面积、修复皮瓣的长、宽均大于足底内侧皮瓣组（P〈0．05）；在术后功能恢复评分上，两组在出院时及出院后，在运动、行走、日常生活能力、皮瓣感觉、外观等方面差异均无统计学差异（P〉0．05）。结论腓肠神经营养血管皮瓣不仅能够单纯修复足跟部皮肤软组织缺损，同时在预后上能够有效地减少患者足部负重后局部发生溃疡及软组织坏死的几率，该方法操作较为简便，能够一期修复较大面积足跟部软组织缺损，因此值得在临床上进行广泛推广。

COMPARISON OF THE CURING EFFECT OF SURAL NEUROVASCULAR FASCIOCUTANEOUS FLAP AND PLANTAR MEDIAL SKIN FLAP IN TREATING SOFT TISSUE DEFECT OF HEEL

Objective By comparing the effect of sural neurovascular fascioeutaneous flap and plantar medial skin flap in treating soft tissue of heel, we will have further study on the clinical effect of the sural neurovaseular fasciocutaneous flap, which will provide theoretical basis for the application of sural neurovascular fasciocutaneous flap in clinic. Methods In dealing with all kinds of soft tissue defect of heel, 23 patients were used plantar medial skin flap, 19 patients were used sural neurovascular fasciocutaneous flap. After treatment, the reparing area, length, width of flaps, the functional score like Fugl - Meyer score, Enneking score, and modified Barthel index, （MBI）were collected and evaluated. We also used SPSS13.0 software and independent two samples t test to analyze these data. Results On repaired wound size, sural neurovaseular faseiocutaneous flap group was larger than plantar medial skin flap group （p 〈 0.05 ） ; no statistical differences have been found on the scores of functional recovery like in sports, walk, daily life ability, feeling et al（p 〉 0.05 ）. Conclusion Sural neurovascular faseiocutaneous flap can be not only used in the treatment of soft tissue defect of heel, also it can prevent side effect like local ulcer and soft tissue necrosis etc. The process of this method is relative simple, and canone phase repair relative large soft tissue defect of heel, thus is highly recommended in clinic.