目的：探讨糖尿病患者应用前锯肌皮瓣对烧伤造成的足踝部软组织缺损的修复效果。方法选取2012年1月—2012年12月间该院收治的足部因烧伤造成的不同程度感染、钢板外露的患者21例，采用前锯肌瓣游离移植，肌瓣上游离植皮的方法进行修复。结果21例患者中手术平均用时（5.91±0.9）h，术后皮瓣均存活。3例患者与术后早期并发肩胛区局部血肿，用胸带固定之后稳定。3例患者主诉瘢痕部位有摩擦疼痛，但在可忍受范围内；2例患者术后侧胸壁出现麻木感，与2个月后症状自行好转；4例患者和对侧相比，存在程度不同的肩关键活动幅度和力量降低，与4个月后恢复正常；1例患者存在轻度翼状肩胛，但无功能受限。结论前锯肌皮瓣对烧伤患者足踝部软组织缺损的修复可获得理想的效果，尤其适用于糖尿病患者。%Objective To investigate the diabetic patients with anterior saw myocutaneous flap to burn caused by the ankle soft tissue defect repair effect. Methods The 2012 January to 2012 December in our hospital from the foot burns caused by different degrees of infection and plate exposure patients 21 cases, the serratus anterior muscle flap free transplantation, muscle flap upstream from the method of skin grafting repair. Results In the 21 patients, the average operation time (5.91+0.9) h, the skin flap survived. 3 patients were treated with local hematoma in the early postoperative period, and the chest band was stable after fixation. 3 patients complained of scar friction of pain, but in the tolerable range; 2 cases of patients with postoperative lateral chest wall appears numbness, and 2 months after symptoms self improved; 4 cases of patients and compared to the contralateral side, there varying degrees of shoulder the key range of motion and strength reduce, and after 4 months to restore normal; 1 patients have mild winging scapula, but no functional limitations. Conclusion The serratus anterior muscle flap for burn patients with ankle and foot soft tissue defect repair can get ideal effect, especially in patients with diabetes mellitus.
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