足跟部皮肤缺损的显微外科修复

目的探讨足跟部组织缺损的显微外科修复方法及临床效果。方法分别采用足底内侧皮瓣、足底外侧皮瓣、足外侧皮瓣、足背皮瓣、内踝上皮瓣、腓肠神经营养血管皮瓣、游离股前外侧皮瓣修复足跟组织缺损17例,皮瓣均含有感觉神经,皮瓣切取面积6 cm×4 cm～14 cm×10 cm。结果17例皮瓣全部成活,经6～30个月随访,依据足跟的感觉和行走功能恢复情况进行综合评价,优8例(47.0%),良7例(41.2%),可2例(11.8%),优良率88.2%。结论足跟部组织缺损首选足底内侧皮瓣修复,创面较大的可选用小腿远端蒂皮瓣,局部皮瓣无法利用者,可考虑游离皮瓣。

Micrusurgical repair of the cutaneous deficiency of retrocalcaneal

Objective To explore the clinical effect and restorative procedure of microsurgical for cutaneous deficiency of heel.Methods The medial plantar flap,lateral plantar flap,flap of lateral foot,dorsalis pedis flap,skin flap pedicled with upper vessel of medial malleolus,sural neurocutaneous flap and anterolateral thigh free flap were taken for repairing tissue defects of heel in 17 cases.All flaps with sensory nerve,and the areas of flaps were 6 cm×4 cm～14 cm×10 cm.Results The skin flap survived in all 17 cases.After six to thirty months follow up,according to the feeling of the heel and the recovery state of walking function for a comprehensive evaluation.The results showed that 8 cases of excellent,7 cases of good,2 cases of fair,and the excellent and good rate was 88.2%.Conclusion The medial plantar flap was the first chioce for tissue defect of heel,distal flaps of the lower leg can be choose for a larger wound,free flap may be used when the local flap can not be used.