组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2022, Vol. 18 ›› Issue (4): 315-.

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不同类型皮瓣修复足踝部软组织缺损的效果对比

  

  • 出版日期:2022-08-01 发布日期:2022-09-06

Effect contrast of different types of skin flaps in repairing soft tissue defects of the foot and ankle　

  • Online:2022-08-01 Published:2022-09-06

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摘要： 目的　对比腓肠神经营养血管皮瓣、足内侧皮瓣、跟外侧皮瓣和足踝上皮瓣修复足踝部软组织缺损的效果。方法　回顾性分析80例足踝部软组织缺损患者的资料，其中腓肠神经营养血管皮瓣修复25例（A组），足内侧皮瓣修复20例（B组），跟外侧皮瓣修复15例（C组），足踝上皮瓣修复20例（D组）。术后均随访6个月，对比各组愈后情况和美国足踝矫形协会的足踝评分（AOFAS）。结果　各组在术后感染、血管危象、外观、质地以及行走功能等方面无明显差异（P＞0.05），A组皮瓣存活率高于C、D组（P＜0.05）； AOFAS评分A组优良率高于其他3组（P＜0.05）。结论　足踝部软组织缺损应根据缺损部位选择合适的皮瓣进行修复，腓肠神经营养血管皮瓣成活率高，有利于患肢功能恢复，是一种良好的修复方法。

关键词: 皮瓣修复, 　足踝部, 　软组织缺损

Abstract: Objective　The effects of sural nerve nutritional vascular flap, medial foot flap, lateral heel flap and foot and ankle epithelial flap for skin flap repair in patients with soft tissue defects of the foot and ankle were compared. To explore the effect of different types of skin flaps in repairing soft tissue defects of the foot and ankle. Methods　The data of 80 patients with foot and ankle soft tissue defects was retrospectively analyzed. Among the 80 patients, 25 patients were repaired with sural nerve nutritional vascular flap (group A), 20 patients with medial foot flap (group B), 15 patients with lateral flap (group C), and 20 patients with ankle and ankle flap (group D). All the patients were followed up for 6 months after operation. The post-healing situation and the American Ankle Orthopedics Association's Ankle Scale (AOFAS) were compared among all the groups. Results　There were no significant differences in the number of cases of infection, vascular crisis, good appearance, soft texture and recovery of walking function among all groups (P>0.05), the flap survival rate in group A were higher than that of group C and group D (P<0.05). The excellent and good rate of AOFAS ankle hindfoot score of group A was higher than that of the other three groups (P<0.05). Conclusion　The soft tissue defect of foot and ankle should be repaired according to the defect location, the sural nerve nutritional vascular flap is a good method for repairing the soft tissue defect of foot and ankle with high survival rate, which is beneficial to the functional recovery of the affected limb.

Key words: Flap repair, 　Foot and ankle, 　Soft tissue defect