腓肠神经皮瓣和股前外皮瓣修复足踝部软组织缺损的研究

发布时间：2018-08-30 18:13

【摘要】：目的比较腓肠神经营养血管逆行岛状筋膜蒂皮瓣和股前外穿支皮瓣修复足踝部软组织缺损的相关并发症、修复范围、修复效果,为这两种皮瓣的选用提供参考。方法2005-2012年,行腓肠神经营养血管逆行岛状筋膜蒂皮瓣50例和股前外穿支皮瓣33例修复足踝部皮肤软组织缺损。回顾性分析两组随访3个月以上皮瓣的成活率、面积、功能和外观满意度及供区并发症。结果1.皮瓣成活率腓肠神经营养血管逆行岛状筋膜蒂皮瓣组为96%,股前外穿支皮瓣组为100%,但无统计学意义(P0.05);2.股前外穿支组皮瓣大小为5.0×4.0cm2～20.0×15.0 cm2,高于腓肠神经营养血管逆行岛状筋膜蒂皮瓣组(P0.05)：3.术后受区功能外形比较发现,两组基本相似(P0.05)；4.供区并发症比较,疤痕增生、瘙痒、色素沉着、植皮区麻木、植皮区感觉异常,差异无统计学意义(P0.05)；5.股前外穿支皮瓣组的供区较为隐蔽,外观恢复满意较高。结论1.腓肠神经营养血管逆行岛状筋膜蒂皮瓣和股前外穿支皮瓣在修复足踝部皮肤软组织缺损时在皮瓣成活率、受区的功能和外观满意度、供区并发症方面有着相同的疗效。2.股前外穿支皮瓣供区隐蔽,能提供更大的供量,且可修复足踝部任意部位,是修复足踝部软组织缺损的理想选择。
[Abstract]:Objective to compare the related complications of sural neurovascular flap pedicled with island fascia pedicle and anterior femoral perforator flap in repairing soft tissue defect of foot and ankle, and to provide reference for the selection of these two kinds of flaps. Methods from 2005 to 2012, 50 cases of sural neurovascular retrograde island fasciocutaneous flap and 33 cases of anterior femoral perforator flap were used to repair the skin and soft tissue defect of foot and ankle. The survival rate, area, function and appearance satisfaction and donor area complications of flap were analyzed retrospectively. Result 1. The survival rate of the flap was 96 in the sural neurovascular pedicle flap group and 100 in the anterior femoral perforator flap group, but there was no statistical significance (P0.05). The flap size of 5 脳 4.0cm2~20.0 脳 15. 0 cm2, in anterior femoral perforator group was higher than that in sural neurovascular retrograde island fascial pedicle flap group (P0.05). After operation, the functional appearance of the recipient area was similar between the two groups (P0.05) 4. 5%. Donor complications, scar hyperplasia, pruritus, pigmentation, skin grafting area numbness, skin grafting area sensory abnormalities, the difference was not statistically significant (P0.05). The donor area of anterior femoral perforator flap group was concealed and the appearance was satisfactory. Conclusion 1. The sural neurovascular reversed island fasciocutaneous flap and anterior femoral perforator flap have the same curative effect in repairing the skin and soft tissue defect of foot and ankle in the aspects of the survival rate of flap, the satisfaction of function and appearance of recipient area, and the complications of donor area. The anterior femoral perforator flap is an ideal choice for repairing soft tissue defect of foot and ankle because of its concealment of donor area, which can provide a larger supply and can repair any part of foot and malleolus.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R658.3

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