游离股前外侧穿支薄皮瓣联合负压封闭引流术修复足踝部创面

摘要

目的 探讨应用游离股前外侧穿支薄皮瓣联合负压封闭引流术(Vacuum Sealing Drainage, VSD)修复足踝部创面的临床效果.方法 2015年12月-2018年6月对16例足踝部皮肤软组织缺损的患者,急诊Ⅰ期予VSD覆盖创面,Ⅱ期应用游离股前外侧穿支薄皮瓣进行修复,皮瓣切取面积10 cm× 7 cm～25 cm×12 cm,供区创面予直接缝合或全厚皮片植皮.结果 术后16例皮瓣全部成活,3例皮瓣远端创面不愈合,经清创及换药等处理后愈合.术后13例获随访,随访时间为3～18个月,皮瓣质地柔软,外观及功能恢复满意,供区恢复良好,无明显瘢痕增生.结论 应用股前外侧穿支薄皮瓣联合VSD技术修复足踝部软组织缺损,可获得满意的临床效果.%Objective To investigate the surgical clinical effect of repairing wounds of the foot and ankle with free thin anterolateral thigh perforator flaps with vacuum sealing drainage technique. Methods From December 2015 to June 2018, 16 patients with soft tissue defects of the foot and ankle were terated, at the first stage, repaired the wounds with vacuum sealing drainage, all were repaired by using free thin anterolateral thigh perforator flaps at the second stage, the area of the flaps was about 10 cm×7 cm～25 cm×12 cm. The donor sites were treated with full-thickness skin grafting from lower abdomen or directly closed. Results All the flaps survived. The flaps healed after debridement and skin grafting. 13 cases were followed up for 3 months to 1.5 years. Both the texture and the shape of all flaps were excellent the function of hand and forearm recovered satisfactorily, the donor sites showed good, no obvious scar hyperplasia. Conclusion Free thin anterolateral thigh perforator flaps with vacuum sealing drainage technique is an effective method for repairing soft tissue defect of the foot and ankle.