探讨VSD负压封闭引流后延期皮瓣移植术的临床疗效

目的探讨清创后VSD负压封闭引流后延期行腓肠神经、小隐静脉远端蒂筋膜皮瓣移植术的临床疗效。方法选择2007年6月～2011年10月足部皮肤软组织缺损行腓肠神经、小隐静脉远端蒂筋膜皮瓣移植术病例37例，采用急诊清创后即行皮瓣移植18例为对照组；采用急诊清创、VSD负压封闭引流后延期行皮瓣移植19例为观察组，术后随访观察患者的并发感染情况，皮瓣成活情况以及术后患者功能恢复优良程度。结果两组抗感染能力、皮瓣成活率、功能恢复优良率差异有统计学意义（P〈0．05）。结论采用VSD技术加延期腓肠神经、小隐静脉远端蒂筋膜皮瓣移植术修复足部皮肤软组织缺损，可以大大降低足部皮肤软组织缺损的感染的发生率，并提高了皮瓣的成活率，改善了患者的患肢功能。

Clinical efficacy of the distally based sural neurofasciocutaneous flaps combined with VSD therapy for reconstruc- tion of soft tissue defects of the foot and ankle

Objective To exlore the Clinical efficacy of the distally based sural neurofasciocutaneous flaps combined with vacuum sealing drainage （VSD） therapy for reconstruction of soft tissue defects of the foot and ankle. Methods Choose 37 cases of distally based sural neurofasciocutaneous flaps combined with VSD therapy for reconstruction of soft tissue defects of the foot and ankle between Jun in 2007 to Oct in 2011, include 19 cases （the observation group） the emergency distally based sural neurofasciocutaneous flaps combined with VSD therapy for reconstruction of soft tissue defects of the foot and ankle and 18 cases （the control group） distally based sural neurofasciocutaneous flaps combined with VSD therapy for reconstruction of soft tissue defects of the foot and ankle. To observe the infection status of patients with follow-up after operation, the flap survived and postoperative functional recovery in patients with good degree. Re-sults Resistance to infection, skin flap survival rate, recovery rate are significantly different （P 〈 0.05）, there was statistical significance. Conclusion Using the distally based sural neurofasciocutaneous flaps combined with VSD therapy for reconstruction of soft tissue defects of the foot and ankle can reduce the skin of the dorsal soft tissue defect of foot in fection rate, and improve the survival rate of skin, improve the limb function of patients.