毁损性小腿难愈创面的皮瓣修复

目的:探讨小腿难愈创面Ⅰ期愈合的效果.方法:局部应用皮瓣植皮,包括岛状皮瓣(腓肠神经筋膜蒂瓣、足背皮瓣、隐神经皮瓣、前臂桡动脉皮瓣、腓肠肌肌皮瓣),游离皮瓣(股前外侧皮瓣、上臂内侧皮瓣),交腿皮瓣植皮等.结果:82例93处创面,伤口Ⅰ期愈合率96.25%,延期愈合2例,再次手术修复2例,其中1例3次手术修复.结论:小腿创面Ⅰ期修复成功率较高,主要由三方面进行治疗处理:①全身营养和原发病治疗,如糖尿病、血管性疾病等;②创面感染控制,坏死组织清除彻底;③带血供的皮瓣覆盖,均可提高伤口Ⅰ期愈合率.

Effect of Repairing Refractory Wounds of Lower leg with Flap

Objective：To explore the method of primary healing of refractory wounds of lower leg.Method：Flap grafting were applied to the local wounds,which included island flap（Sural nerve fascia pedicle flap,dorsal foot flap,saphenous nerve flap,radial forearm artery flap,gastrocnemius muscle flap）,free flap（Anterolateral thigh flap and medial upper arm flap） and cross-leg flap etc.Results：Among of 82 patients（93 wounds）,primary healing rate of the wounds was 96.25%,2 cases were delayed healing,one case received second operation and another one case recieved third operation.Conclusion：Lower leg wounds has higher primary healing rate with flap repair.The major treatment points are three factors：1.Nutrition and treatment of primary diseases,such as diabetes,vascular disease etc.2.Controlling wound infection and complete removal of necrosis tissue.3.Vascularized flap coverage can improve primary healing rate.