穿支皮瓣游离移植修复足部创面缺损

目的 探讨应用穿支皮瓣游离移植修复足部创面缺损的临床疗效.方法 2006年3月至2009年12月,应用下肢4种穿支皮瓣游离移植修复20例足部创面缺损患者,男15例,女5例;年龄18～61岁,平均28.5岁;左侧7例,右侧13例.缺损创面部位:足背12例,足跟足底部5例,足踝部3例;创面大小为2.0 cm×3.5 cm～12.0 cm×18.0 cm.皮瓣选择:股前外侧穿支皮瓣5例,股前内侧穿支皮瓣7例,腓浅动脉穿支皮瓣5例,腓动脉穿支皮瓣3例. 结果 本组20例患者皮瓣全部成活,术中2例患者出现血管危象,经及时处理后血运恢复.20例患者术后获3～6个月(平均5.2个月)随访,皮瓣质地、外观均良好,其中13例吻合皮神经恢复了保护性感觉,供区愈合可,功能无影响.结论 应用穿支皮瓣游离移植修复足部创面缺损,临床效果满意,是修复此类创面的较理想选择.

Reconstruction of soft-tissue defects in foot using free graft of perforator flap

Objective To discuss the clinical effects of reconstruction of soft-tissue defects in foot using free graft of perforator flap. Methods From March 2006 to December 2009, 4 kinds of free graft of perforator flap form the lower extremity were used for reconstruction of soft-tissue defects in foot in 20 cases.They were 15 males and 5 females. Their ages ranged from 18 to 61 years old, with an average of 28. 5 years.Seven cases had defects in the left foot and 13 in the right. The defects were located in the dorsal foot in 12cases, the heel in 5 and ankle in 3. Five were reconstructed with anterolateral thigh perforator flaps, 7 with anteromedial thigh perforator flaps, 5 with superficial peroneal artery perforator flaps and 3 with peroneal artery perforator flaps. The defect areas ranged from 2.0 cm × 3.5 cm to 12. 0 cm × 18. 0 cm. Results All the flaps survived. Intraoperative vascular crisis occurred in 2 cases but the blood flow was restored after timely treatment. Follow-ups of 3 to 6 months showed all the flaps had a good appearance. Thirteen cases restored a good protective sensibility after nerve anastomosis. The donor sites healed well without sacrifice of their normal function. Conclusion Free graft of perforator flap is an effective method to reconstruct soft-tissue defects in foot.