近端带蒂交腿皮瓣治疗儿童足踝部大面积皮肤缺损

目的 回顾分析近端带蒂交腿皮瓣治疗儿童足踝部创伤后大面积皮肤缺损的临床效果.方法 2004年12月～2007年12月收治的8例足踝部严重外伤患儿,均伴有大面积皮肤缺损,严格清创后,3例行撕脱皮肤原位缝合术,3周左右皮肤坏死,Ⅱ期行交腿皮瓣手术,5例行Ⅰ期交腿皮瓣手术,术后下肢石膏固定保护皮瓣,3周断蒂.结果 所有皮瓣成活良好,供皮区伤口愈合良好,平均随访16个月,步态良好,踝关节活动无受限.结论 近端带蒂交腿皮瓣操作简单,不依赖知名血管,治疗儿童大面积皮肤缺损安全有效.

Proximally pedicled cress-leg flap for severe foot and ankle trauma in children

Objective To review the clinical outcomes of the classical cross-leg flaps for severe lower-extremity soft-tissue defects in children. Methods Eight children were referred to our hospital between December of 2004 and December of 2007 with smashed injuries of foot and ankle combined with severe soft-tissue defects. Immediately after thorough debridement to the wounds, five of 8 were given proximally pedicled cross-leg flaps from the opposite leg to cover the defects, three were given original suture to the degloving soft-tissue, which got necrosis later and were replaced by cross-leg flaps 3 weeks after injury. The legs were immobilized with plaster to protect the flaps. The flaps were divided 3 weeks after operation. Results All the flaps survived successfully without complications. After 16 months' follow-up, full ankle range of motion was achieved in all cases. Conclusions Proximally pedicled cross-leg flap is still a safe choice in children, because of its easy dissection and reliable pedicle without compromising the major vessels.