切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 22 -25. doi: 10.3877/cma.j.issn.1674-0785.2021.01.004

所属专题: 文献

临床研究

腓肠神经延迟皮瓣修复足部软组织缺损的临床效果
张功林1, 师富贵1, 王行高1, 何如祥1, 胡军1,(), 孙萍1, 龚铁军2, 王耀华2, 邹永刚2   
  1. 1. 730050 兰州,甘肃省兰州市兰州手足外科医院手外科
    2. 734000 甘肃张掖,甘肃省河西学院附属张掖人民医院骨科
  • 收稿日期:2020-08-02 出版日期:2021-01-15
  • 通信作者: 胡军
  • 基金资助:
    兰州市科学技术局项目(2018-4-60)

Clinical effect of delayed sural neurocutaneous flap for reconstruction of soft-tissue defect of the foot

Gonglin Zhang1, Fugui Shi1, Xinggao Wang1, Ruxiang He1, Jun Hu1,(), Ping Sun1, Tiejun Gong2, Yaohua Wang2, Yonggang Zou2   

  1. 1. Department of Hand Surgery, Lanzhou Hand and Foot Surgery Hospital, Lanzhou 730050, China
    2. Department of Orthopaedics, Zhangye People's Hospital Affiliated to Hexi College, Zhangye 734000, China
  • Received:2020-08-02 Published:2021-01-15
  • Corresponding author: Jun Hu
引用本文:

张功林, 师富贵, 王行高, 何如祥, 胡军, 孙萍, 龚铁军, 王耀华, 邹永刚. 腓肠神经延迟皮瓣修复足部软组织缺损的临床效果[J/OL]. 中华临床医师杂志(电子版), 2021, 15(01): 22-25.

Gonglin Zhang, Fugui Shi, Xinggao Wang, Ruxiang He, Jun Hu, Ping Sun, Tiejun Gong, Yaohua Wang, Yonggang Zou. Clinical effect of delayed sural neurocutaneous flap for reconstruction of soft-tissue defect of the foot[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(01): 22-25.

目的

观察腓肠神经延迟皮瓣修复足部软组织缺损的临床应用效果。

方法

自2008年1月至2018年1月,甘肃省兰州市兰州手足外科医院骨科腓肠神经延迟皮瓣修复足部软组织缺损36例,男22,女14;年龄26~82岁,平均(50.5±20.4)岁;软组织缺损范围(6 cm×4.5 cm)~(22 cm×15 cm);皮瓣延迟时间8~12 d,平均(9.7±2.4)d。皮瓣延迟期间创面暂时应用负压封闭引流覆盖。延迟皮瓣修复受区创面后,供区用中厚游离植皮修复。

结果

延迟皮瓣全部成活,2例皮瓣发生小的皮缘裂开,术后2周自然愈合。1例供区植皮发生小片坏死,经游离植皮愈合。术后随访1.5~4.5年,平均(3.5±1.4)年,所有软组织缺损修复成功,皮瓣颜色、质地与外形较好,本组取得了较满意的临床效果。

结论

腓肠神经延迟皮瓣修复足部软组织缺损安全、可靠,很适用于伴高风险患者或皮瓣切取较大者。

Objective

To report the clinical effect of delayed sural neurocutaneous flap for the reconstruction of soft-tissue defect of the foot .

Methods

From January 2008 to January 2018, 36 patients (22 men and 12 women) with soft-tissue defect in the foot underwent reconstruction with a delayed sural neurocutaneous flap. They ranged in age from 26 to 82 years [mean of (50.5±20.4) years]. Soft-tissue defect size in the foot ranged from 16 cm×4.5 cm to 22 cm×15 cm. The delay period ranged from 8 to 12 days [mean of (9.7±2.4) days]. Temporary wound coverage was achieved by vacuum sealing drainage during the delay period. After the delayed flap was used to repair the wound of the recipient area, donor site was covered using split-thickness free skin grafts.

Results

All the delayed flaps had survived completely. Two flaps developed small wound dehiscence, which spontaneously healed 2 weeks after surgery. In one case, the skin grafts in the donor area had small necrosis and were healed with free skin grafts. Follow-up period ranged from 1.5 to 4.5 years [mean of (3.5±1.4) years] postoperatively. All soft-tissue defects were successfully repaired with good color, texture, and contour of the flaps. Satisfactory clinical results were obtained in this series.

Conclusion

Delayed sural neurocutaneous flap for reconstruction of soft-tissue defect of the foot is safe, reliable, and particularly suitable for high-risk patients or harvesting a large flap.

图1 腓肠神经延迟皮瓣修复足部软组织缺损患者情况及预后。图a为术前创面外形;图b为术前受区与皮瓣设计;图c为术中修复后供区与受区外形;图d为修复后4周外形;图e为术后1.5年受区外形;图f为术后1.5年供区外形
1
Donski PK, Fogdestam I. Distally based fasciocutaneous flap from the sural region. A preliminary report [J]. Scand J Plast Reconstr Surg, 1983, 17(3): 191-196.
2
Masquelet AC, Romana MC, Wolf G. Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg [J]. Plast Reconstr Surg, 1992, 89(6): 1115-1121.
3
Korompilias A, Gkiatas I, Korompilia M, et al. Reverse sural artery flap: a reliable alternative for foot and ankle soft tissue reconstruction [J]. Eur J Orthop Surg Traumatol, 2019, 29(2): 367-372.
4
Dhua S, Manashree S, Tilak BG. The clinical outcome of perforator based sural artery and propeller flaps in reconstruction of soft tissue of extremities [J]. World J Plast Surg, 2019, 8(1): 3-11.
5
Talukdar A, Yadav J, Purkayastha J, et al. Reverse sural flap - A feasible option for oncological defects of the lower extremity, ankle, and foot: Our experience from Northeast India [J]. South Asian J Cancer, 2019, 8(4): 255-257.
6
王爽, 舒衡生, 石博文, 等. Ilizarov技术结合腓肠神经或隐神经营养血管皮瓣治疗足踝部软组织缺损伴创伤后马蹄足畸形 [J]. 中华骨科杂志, 2019, 39(5): 305-312.
7
Ince B, Daaci M, Altuntas Z, et al. Versatility of delayed reverse-flow islanded sural flap for reconstructing pretibal defects among high-risk patients [J]. Ann Saudi Med, 2014, 34(3): 235-240.
8
Suzuki A, Fujiwara M, Mizukami T, et al. Delayed distally-based super sural flap: evaluation by indocyanine green fluorescence angiography [J]. J Plast Reconstr Aesthet Surg, 2008, 61(4): 467-469.
9
Baumeister SP, Spierer R, Erdmann D, et al. A realistic complication analysis of 70 sural artery flaps in a multimorbid patient group [J]. Plast Reconstr Surg, 2003, 112(1): 129-142.
10
Perumal R, Bhowmick K, Reka K, et al. Comparison of reverse sural artery flap healing for traumatic injuries above and below the ankle joint [J]. J Foot Ankle Surg, 2019, 58(2): 306-311.
11
Grandjean A, Romana C, Fitoussi F. Distally based sural flap for ankle and foot coverage in children [J]. Orthop Traumatol Surg Res, 2016, 102(1): 111-116.
12
Zheng H, Liu J, Dai X, et al. The distally based sural flap for the reconstruction of ankle and foot defects in pediatric patients [J]. Ann Plast Surg, 2016, 77(1): 97-101.
13
Tajsic N, Winkel R, Husum H. Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and clinical outcomes [J]. Injury, 2014, 45(3): 469-477.
14
Liu L, Zou L, Li Z, et al. The extended distally based sural neurocutaneous flap for foot and ankle reconstruction: a retrospective review of 10 years of experience [J]. Ann Plast Surg, 2014, 72(6): 689-694.
15
蒋协远, 王大伟. 骨科临床疗效评价标准 [M]. 北京: 人民卫生出版社, 2005: 310-312.
16
张功林, 甄平, 陈克明, 等. 延迟逆行股前外侧带蒂皮瓣修复膝部软组织缺损16例临床随访 [J]. 中华显微外科杂志, 2016, 39(3): 232-235.
17
Mahajan RK, Srinivasan K, Singh M, et al. Management of post-traumatic composite bone and soft tissue defect of leg [J]. Indian J Plast Surg, 2019, 52(1): 45-54.
18
Robert N. Negative pressure wound therapy in orthopaedic surgery [J]. Orthop Traumatol Surg Res, 2017, 103(1S): S99-S103.
[1] 卢芳连, 汤莉, 何河北, 李建云, 欧栓机, 陈燕, 陈娇妹. 责任护士主导的疼痛管理在膝关节置换术后的应用[J/OL]. 中华关节外科杂志(电子版), 2024, 18(02): 285-289.
[2] 王杰, 袁泉, 王玥琦, 乔佳君, 谭春丽, 夏仲元, 刘守尧. 溃疡油在糖尿病足溃疡治疗中的应用效果及安全性观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 480-484.
[3] 高秋芳, 张万锋, 盛泉音, 马彬. 足底内侧皮瓣联合腓动脉穿支皮瓣修复足跟部巨大恶性黑色素瘤切除后创面的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 491-497.
[4] 别瑶, 曹志斌, 辛静, 王健楠, 惠宗光. 应用基质血管成分细胞治疗糖尿病足溃疡的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 453-456.
[5] 姜珊, 李湘燕, 田硕涵, 温冰, 何睿, 齐心. 采用优化抗感染治疗模式改善糖尿病足感染预后的临床观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 398-403.
[6] 周荣, 巨积辉, 刘禹城, 杨亮, 郭礼平, 柳志锦, 王桂洋, 杨林, 程俊楠, 黄永涛, 葛成伟, 金乾衡, 曹阳, 王石, 董帅. 双侧股前外侧皮瓣修复全足皮肤脱套伤创面的血供重建方式及疗效分析[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(04): 299-306.
[7] 谢芬, 陈洁, 张媛媛, 刘茜, 胡芬, 李恭驰, 李炳辉, 金环. 移动健康管理模式在糖尿病足管理中的应用效果观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(04): 335-340.
[8] 杨丽, 李文颖, 田园, 周林熙, 王伟. 脂质水胶体硫酸银敷料和蔗糖八硫酸盐敷料在糖尿病足溃疡中的应用进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(03): 271-275.
[9] 苏永涛, 王春雷, 徐广琪, 关中正, 焦伟, 隋颖. 胫骨骨膜牵张术联合富血小板血浆对治疗糖尿病足溃疡的疗效观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(03): 238-244.
[10] 孙艺玮, 陈炜, 秦巍, 杜景辰, 孟昕, 周永军. 血管腔内介入治疗糖尿病足合并下肢动脉硬化闭塞症患者术后再狭窄与血清炎症因子的相关性[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(01): 34-40.
[11] 李亚萍, 张萌, 李博驹, 刘晨瑞, 苟国娥, 李嘉昕, 张玉凤, 席淼, 邓慧玲. 干扰素诱导蛋白16-干扰素基因刺激因子通路在柯萨奇病毒A6型感染手足口病患儿的表达及其临床意义[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(03): 135-141.
[12] 张升荣, 李晓东, 王伟. B族链球菌感染分型对孕产妇未足月胎膜早破的预测价值及其与绒毛膜羊膜炎的关系[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(03): 170-175.
[13] 吕巧荣, 张燕, 付敏. 232例手足口病患儿流行特征及预后风险模型的构建与验证[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(02): 91-99.
[14] 白钜澄, 崔国庆, 邵振兴. 冈上肌/冈下肌足印区及其分界线的解剖学研究进展[J/OL]. 中华肩肘外科电子杂志, 2024, 12(02): 184-189.
[15] 黄晨, 庄炜钊, 刘合祝, 李永生, 王倩, 唐郁宽. 富血小板凝胶联合腔内血管成形术治疗缺血性糖尿病足的研究[J/OL]. 中华介入放射学电子杂志, 2024, 12(01): 27-32.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?