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腓腸神經(jīng)皮瓣和股前外皮瓣修復(fù)足踝部軟組織缺損的研究

發(fā)布時(shí)間:2018-08-30 18:13
【摘要】:目的比較腓腸神經(jīng)營(yíng)養(yǎng)血管逆行島狀筋膜蒂皮瓣和股前外穿支皮瓣修復(fù)足踝部軟組織缺損的相關(guān)并發(fā)癥、修復(fù)范圍、修復(fù)效果,為這兩種皮瓣的選用提供參考。方法2005-2012年,行腓腸神經(jīng)營(yíng)養(yǎng)血管逆行島狀筋膜蒂皮瓣50例和股前外穿支皮瓣33例修復(fù)足踝部皮膚軟組織缺損。回顧性分析兩組隨訪3個(gè)月以上皮瓣的成活率、面積、功能和外觀滿(mǎn)意度及供區(qū)并發(fā)癥。結(jié)果1.皮瓣成活率腓腸神經(jīng)營(yíng)養(yǎng)血管逆行島狀筋膜蒂皮瓣組為96%,股前外穿支皮瓣組為100%,但無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);2.股前外穿支組皮瓣大小為5.0×4.0cm2~20.0×15.0 cm2,高于腓腸神經(jīng)營(yíng)養(yǎng)血管逆行島狀筋膜蒂皮瓣組(P0.05):3.術(shù)后受區(qū)功能外形比較發(fā)現(xiàn),兩組基本相似(P0.05);4.供區(qū)并發(fā)癥比較,疤痕增生、瘙癢、色素沉著、植皮區(qū)麻木、植皮區(qū)感覺(jué)異常,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);5.股前外穿支皮瓣組的供區(qū)較為隱蔽,外觀恢復(fù)滿(mǎn)意較高。結(jié)論1.腓腸神經(jīng)營(yíng)養(yǎng)血管逆行島狀筋膜蒂皮瓣和股前外穿支皮瓣在修復(fù)足踝部皮膚軟組織缺損時(shí)在皮瓣成活率、受區(qū)的功能和外觀滿(mǎn)意度、供區(qū)并發(fā)癥方面有著相同的療效。2.股前外穿支皮瓣供區(qū)隱蔽,能提供更大的供量,且可修復(fù)足踝部任意部位,是修復(fù)足踝部軟組織缺損的理想選擇。
[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.
【學(xué)位授予單位】:新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2015
【分類(lèi)號(hào)】:R658.3

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