内踝上皮支皮瓣在糖尿病足部溃疡的临床应用

目的　探讨应用内踝上皮支皮瓣修复糖尿病足部溃疡的临床疗效。 方法　2012年3月至2015年3月，在内科治疗控制血糖的基础上，对糖尿病足合并Wagner分级2级以上的足部溃疡采用内踝上皮支皮瓣修复32例共38足。 结果　术后皮瓣血运良好，2例皮瓣远端小面积坏死，经换药后治愈，l例半年后因糖尿病血糖控制不良，外伤后伤口不愈合再次发生溃疡，并出现糖尿病足坏疽，行截肢处理。本组病例随访2～18个月，皮瓣成活良好，质地优良，耐磨压，大部分恢复保护性感觉，患足可负重行走，功能恢复满意。 结论　应用内踝上皮支皮瓣修复糖尿病足部溃疡临床效果良好，手术操作简便易行，能有效的提高患者生活质量。

The medial supra-malleolus perforator flap for the clinical treatment of diabetic foot ulcers

Objective　To explore the clinical application of the supra-malleolus perforator flap for repair of diabetic foot ulcers．Methods From March 2012 to March 2015. There were 38 feet in 32 patients developed diabetic foot ulcers with at least wagner II grade. The first medical treatment was to control blood glucose, then the supra-malleolus perforator flap was adopted to repair diabetic foot ulcers．Results The flaps survived totally in 38 feet，and the distal partial necrosis and secondary free-skin grafting were further conducted in 2 cases. Thirty-two cases were followed-up for 2 to 18 months，the circulation，color and texture of the flaps were excellent．The appearance and function of ankle joints were good．Conclusion The supra-malleolus perforator flap has sufficient blood supply and a high survival rate；It is convenient in design，dissection and without sacrifice of major arteries. So，it is an effective method to repair diabetic foot ulcers. This method is effective in improving the quality of life of patients.