足跟部皮肤缺损一期修复的围手术期处理

目的 探讨足跟部皮肤缺损修复的围手术期处理。方法 本组４８例，采用６种不同类型轴型皮瓣、肌皮瓣进行修复。足底内侧皮瓣１４例，趾短屈肌皮瓣４例，展肌皮瓣３例，背阔肌皮瓣７全人侧远端胫后动脉皮肤穿支皮瓣１６例，足背皮瓣２例。结果 手术全部成功，随访３个月～４年，４３例皮瓣有良好感觉功能，负重后无溃疡发生，３例感觉功能差。其中１例负重后皮瓣肿用菜水泡形成。结论 修复方法根据病情而定，带蒂皮瓣注意保护好丽

SURGICAL INTERVENTION IN THE TREATMENT OF SKIN DEFECT OF HELL

OBJECTIVE: To investigate the efficacy of different flaps in the treatment of skin defect of hell. METHODS: Forty-six patients with skin defect of hell were adopted in this study. There were 39 males and 7 females, 29 years old in average. Six different flaps were applied in the reconstructive operation, 14 plantaris medialis flaps, 4 flexor digitorum brevis muscle flaps, 3 abductor hallucis flaps, 7 latissimus dorsi flaps, 16 distal medialis flaps of leg pedicled with the cutaneous branch of posterior fibial artery, 2 foot dorsum flaps. RESULTS: All the flaps survived, primary healing of the wound in 45 cases and secondary healing in 1 case. Followed up for 3 months to 4 years, 43 patients obtained good flap sensation, the function of weight bearing were satisfied in 43 patients. CONCLUSION: The six different flaps should be applied according to patient's condition individually. The sensation of flap is very important to the function of weight bearing.