足踝部软组织缺损修复方法的选择

目的总结足踝部软组织缺损修复的经验,探讨足踝部软组织缺损修复方法。方法本组130例(141足)足踝部软组织缺损,根据修复方法分为游离皮片、局部皮瓣、带血管蒂轴形皮瓣、交腿皮瓣和游离皮瓣移植;按创面愈合和功能恢复情况分为:优,创面一期愈合、功能恢复良好;良,创面有少许水疱坏死,通过换药自行愈合;一般,坏死的比例在10%以下、植皮封闭创面;差,坏死比例在10%以上,需重新考虑创面封闭。结果游离植皮优良率91.68%;局部皮瓣优良率91.30%;小腿带血管蒂轴形皮瓣优良率90.91%;游离皮瓣优良率90.00%;交腿皮瓣优良率93.33%;五种封闭创面方法优良率经Sas统计软件包作χ2检验,P>0.05,差别没有显著性意义。结论足踝部软组织缺损的修复应根据创面及其周围情况选择适宜的修复方法。

Operative Approaches in the Repair of Soft Tissue Defects of Ankle

Objective To summarize the experience and lesson on the repair of soft tissue defects in ankle,and discuss repair methods.Methods One hundred thirty cases(141 feet ) of soft tissue defects in ankle were retrospectively analyzed.Five kinds of repair methods were used,which was free skin graft,regional flap graft,axial flap graft with blood vessel pedicle,cross-leg flap graft and free skin flaps.Wound healing was graded as excellent,good,general and bad.The excellent means primary healing and no inflammation or necrosis with fine functional restoration.Good:a little hydroa around the wound but healing after change dressings.General:the necrosis proportion was below 10% and skin graft was needed.Bad:the necrosis proportion was above 10%,the second time of wound seal had to be considered.Results The excellent or good result was 91.68% by free skin graft,91.30% by regional flap graft,90.91% by axial flap graft,93.33% by cross-leg flap graft and 90% by free skin flaps.No significant difference was found between five methods (P>0.05,chi-square test by SAS).Conclusion The repair methods for the wound of ankle should be chosen according to the wound and surrounding status.