摘要
目的研究应用胫后动脉皮穿支皮瓣修复小腿及足软组织缺损的临床疗效。方法选择2005—2012年收治的小腿及足软组织缺损患者共84例,分为治疗组和对照组各42例,治疗组应用胫后动脉皮穿支皮瓣进行修复,对照组应用小腿腓肠神经皮神经营养血管等其他皮瓣进行修复。对两组缺损修复后皮瓣存活率、质量及外形进行分析比较。结果 84例皮瓣中80例存活良好,4例皮瓣因静脉回流障碍导致皮瓣肿胀,远端发绀,少部分坏死,但经换药后均完全愈合。两组皮瓣术后并发症发生率比较,差异无统计学意义(P>0.05),但皮瓣外观形态不满意发生率比较,差异有统计学意义(P<0.05)。结论胫后动脉皮穿支皮瓣因穿支位置较恒定,只需术前准确定位便可保证切取皮瓣安全可靠且不损伤主动脉干,对下肢形态和功能影响小,符合组织移植原则,是一种较理想的修复小腿及足部软组织缺损的皮瓣。
Objective To study the clinical efficacy of the posterior tibial artery perforator flap for repairing lower leg and foot soft tissue defect.Methods From 2005 to 2012,84 patients with leg and foot soft tissue defects were treated and randomly divided into two groups with 42 cases in each group.The treatment group was repaired with the posterior tibial artery perforator flap,while the control group with other flaps like sural neurocutaneous vascular flap.The survival rate,quality and the profile of flap after repairing between the two groups were performed the comparative analysis.Results Among 84 cases of flaps,80 flaps survived well,but other 4 flaps were swollen,distal cyanosis and partial necrosis due to the disturbance of venous return,which were completely healed after dressing.There was no statistical significance in difference of complications rates between the two groups（P0.05）,while there was statistically significant difference in the comparison of unsatisfied rate of the flap profile between the two groups（P0.05）.Conclusion As the constant position of the posterior tibial artery perforator flap,if the preoperative positioning is accurate,the flap cutting will be safe,reliable,and will not damage the trunk of the aortic with little impact on lower limb morphology and function,which accords with the basic primciples of tissue transplantation and is an ideal flap to repair soft tissue defects of the leg and foot.
出处
《现代医药卫生》
2013年第1期23-24,共2页
Journal of Modern Medicine & Health
