摘要
目的探讨选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损的疗效。方法 2013年4月—2015年8月,收治8例不同原因导致的足跟及足跟后区缺损患者。男6例,女2例;年龄15~49岁,平均31.2岁。创面范围为14 cm×10 cm~19 cm×14 cm。手术切取对侧股前外侧皮瓣,将拟覆盖足底非承重区和足跟后区部分行不同程度修薄。皮瓣切取范围为14 cm×10 cm~19 cm×14 cm。供区游离植皮修复。结果术后皮瓣均顺利成活,创面Ⅰ期愈合。2例发生供区局部皮片坏死,经换药后愈合;其余植皮均顺利成活。患者均获随访,随访时间8~20个月,平均12.3个月。患者恢复正常行走,其中2例皮瓣发生破损,经换药后自愈。7例皮瓣外观无臃肿,不影响穿鞋;1例于术后1年行二期皮瓣修薄术。结论选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损,可获得较理想足部外观和功能。
Objective To investigate the effectiveness of selectively thinning of the free anterolateral thigh flap in repair of the heel skin and soft tissue defect. Methods Between April 2013 and August 2015, 8 patients with tissue defect of heel caused by different reasons were recruited. There were 6 males and 2 females with an average age of 31.2 years(range, 15-49 years). The size of wound ranged from 14 cm×10 cm to 19 cm×14 cm. All the wounds were repaired with the contralateral free anterolateral thigh flap. The partial flap which was going to repair the defects of the heel and nonweight-bearing area of planta pedis was selectively thinned. The size of flap ranged from 14 cm×10 cm to 19 cm×14 cm.The donate site was repaired by skin grafting. Results All flaps survived after operation, and wounds healed by first intention. The marginal necrosis of skin graft occurred in 2 cases, and healed after changing the dressing. The other skin grafts survived. All patients were followed up 8-20 months(mean, 12.3 months). All patients could walk normally. During follow-up, 2 flaps were injured and cured after symptomatic management. The appearance of flap was good in 7 cases with no influence in wearing shoes. Only 1 patient received the second-stage surgery of thinning the flap after 1 year.Conclusion Application of the selectively thinning of the free anterolateral thigh flap can repair the heel skin and soft tissue defects, and achieve an ideal appearance and function.
引文
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