组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (4): 371-.

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应用顺行和逆行足背皮瓣修复小腿和足部创面

  

  • 出版日期:2023-08-01 发布日期:2023-09-06

 Application of anterograde and reverse dorsalis pedis skin flap for repairing defects in the lower leg and foot

  • Online:2023-08-01 Published:2023-09-06

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摘要：

目的　探讨应用顺行和逆行足背皮瓣修复小腿和足部创面的效果。方法　回顾性分析我科 2018 年 1 月至
2021 年 12 月采用足背皮瓣修复的软组织缺损病例 14 例，其中 9 例采用顺行皮瓣，5 例采用逆行皮瓣。供瓣区直接
植皮修复，或用人工真皮支架覆盖 2~3 周后植皮修复。结果　皮瓣全部存活，一期愈合。供区植皮大部分存活，少
部分皮片成活不佳，换药后愈合。随访皮瓣外观良好，直接植皮修复的供区外观欠佳，应用人工真皮支架 + 二期植
皮修复的供区外观明显改善，足部功能正常。结论　足背皮瓣是修复下肢及足部软组织缺损的可靠选择，应用人工
真皮支架覆盖供区 + 二期植皮能明显提高供区植皮成活率并改善外观。

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Abstract:

Objective　To explore the application of anterograde and reverse dorsalis pedis skin flap in the repair of the de
fects in the lower leg and foot. Methods　From Jan. 2018 to Dec. 2021, 14 cases of dorsalis pedis flap were used to repair the
defects in the lower leg and foot, including 9 cases of anterograde dorsalis pedis skin flap and 5 cases of reverse dorsalis pedis
skin flap. The donor site was repaired with skin graft directly or covered with artificial dermis followed by skin graft 2-3 weeks
later. Results　All flaps survived well with primary healing. Most of skin grafts survived and the residual wound healed with
dressing change. In the follow-up period, the appearance of the flap was satisfactory. The appearance of donor sites repaired
with artificial dermis and secondary skin graft were better than that repaired by skin graft only. Foot function recovered well.
Conclusion　Dorsalis pedis flap is a reliable choice for repairing defects in the lower leg and foot. The application of artificial
dermis before skin graft can obviously increase the survival rate and improve the long-term appearance of donor site.

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