组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (6): 541-.

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游离股前外侧皮瓣修复足底负重区软组织缺损的效果

  

  • 发布日期:2023-12-28

 The effectiveness of free anterolateral thigh flap on repairing soft tissue defects in the plantar load-bearing area

  • Published:2023-12-28

摘要:

目的 探索游离股前外侧皮瓣(ALTF)修复足底负重区软组织缺损的临床效果。方法 选取 2020 年 3 月至 2021 年 3 月就诊的足底负重区软组织缺损患者 12 例,软组织缺损范围 8 cm×6 cm~26 cm×16 cm,急诊清创后用ALTF 进行修复,供区创面予以直接缝合或全厚皮片植皮。结果 本组 12 例皮瓣均成活,有 2 例皮瓣边缘出现少许渗出,且合并创面不愈合,经换药以及清创、抗炎等处理后自愈。术后随访 6~12 个月,皮瓣质地较为柔软,外观恢复情况良好。术后给予理疗以及功能康复训练,足部活动范围以及力量基本恢复正常。末次随访时患者均恢复正常步态。末期随访足底区感觉功能 S1 级 1 例(8.33%),S2 级 3 例(25.00%),S3 级 6 例(50.00%),S4 级 2 例(16.67%)。术后随访第 1 周、第 3 个月及第 6 个月的足功能评分分别为 46.25±5.27、73.14±8.42、88.74±10.51。统计分析显示Maryland 足功能评分第 6 个月>第 3 个月>第 1 周(P<0.05)。结论 对足底负重区软组织缺损行游离 ALTF 技术修复,临床效果较好,值得临床推广应用。

关键词:

Abstract:

Objective To explore the clinical effect of free anterolateral thigh flap (ALTF) for repairing soft tissue defects
in the plantar load-bearing area. Methods From March 2020 to March 2021, 12 patients with soft tissue defects in the
plantar weight-bearing area were selected, the soft tissue defect ranged from 8 cm×6 cm to 26 cm×16 cm. After emergency
debridement, ALTF was used to repair soft tissue defects, and the donor site wounds were directly sutured or grafted with full
thickness skin. Results All 12 flaps survived in this group, with 2 cases showing slight exudation at the edge of the flap and
accompanied by non healing of the wounds. The wounds self-healed after dressing change, debridement, anti-inflammatory
treatment, and other treatments. All 12 patients were followed up for 6-12 months after operation, and the skin flap texture was
relatively soft and the appearance recovery was good. After operation, physical therapy and functional rehabilitation training were
carried out under the guidance of medical staff, and the range of foot movement and strength were basically restored. At the last
follow-up, all patients returned to normal gait. During the final follow-up, there was 1 case with S1 grade sensory function in
the plantar area (8.33%), 3 cases with S2 grade (25.00%), 6 cases with S3 grade (50.00%), and 2 cases with S4 grade (16.67%).
The postoperative foot function scores at week 1, month 3, and month 6 were 46.25±5.27, 73.14±8.42 and 88.74±10.51,
respectively. Statistics showed that Maryland’s foot function score in the 6th month>3rd month>1st week (P<0.05). Conclusion
The use of free ALTF technology for repairing soft tissue defects in the plantar load-bearing area of patients has shown good
clinical results and is worth promoting and applying in clinical practice.

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