目的 探讨拇展肌肌皮瓣修复足跟部恶性肿瘤软组织缺损的临床疗效.方法 采用带血管神经蒂的拇展肌肌皮瓣修复足跟部恶性肿瘤广泛切除术的软组织缺损26例,其中伴有溃疡出血者9例.皮肤缺损面积(2～6)cm×(5～9)cm,肌皮瓣切取面积(4～8)cm×(7～11)cm,深层拇展肌肌肉面积3 cm×7 cm,供区全部应用中厚皮片游离植皮.结果 术后26例肌皮瓣完全存活,创面Ⅰ期愈合.随访时间7～37个月,平均22个月,局部无复发;肌皮瓣质地优良,外观满意,行走正常,皮肤感觉恢复良好.结论 拇展肌肌皮瓣血运可靠,转移方便,是修复足跟部位恶性肿瘤广泛切除软组织缺损的良好选择.%Objective To evaluate the clinical application of the abductor hallucis flap in restoration of the soft-tissue defects in calcar pedis malignant. Methods We utilized abductor hallucis flap with neurovascular pedicle to restore soft-tissue defects in 26 cases of calcar pedis Malignant. Among these cases, 9 cases were combined with ulcer and bleeding, the sizes of skin defects being 2～6 cm ×5～9 cm, myocutaneous flap were 4～8 cm ×7 ～11 cm,muscular of abductor hallucis 3 cm ×7 cm. Intermediate thickness free skin grafts were used in donor site. Results All 18 cases of musculo cutaneous flap survived after surgery. Wound healing were stage Ⅰ. After 7 ～ 36 months of follow-up, we observed no complications or local recurrence. The muscle flaps maintained good quality with satisfactory appearance of satisfaction, proper walk, comfort feel of musculocutaneous flap. Conclusion The abductor hallucis flap has advantages, such as reliable blood supply and easy to transfer. It is a good choice in restoration of soft tissue defects in calcar pedis malignant.
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