目的:评价逆行腓动脉穿支筋膜蒂皮瓣和逆行胫后动脉穿支筋膜蒂皮瓣对修复小腿下段和足踝部皮肤缺损的临床效果和并发症.方法:回顾性分析在我院运用腓动脉穿支筋膜蒂皮瓣和逆行胫后动脉穿支筋膜蒂皮瓣修复小腿下段和足部皮肤缺损的患者,统计分析皮瓣的成活与坏死率、皮瓣的功能以及并发症.结果:腓动脉组一期存活率高于胫后动脉组,差异有统计学意义(P<0.05).腓动脉组皮瓣功能指标评分与胫后动脉组比较无明显差异(P>0.05).腓动脉组增生性瘢痕、瘙痒、色素沉着、植皮区麻木、植皮区痛觉异常并发症发生率均显著低于胫后动脉组,差异有统计学意义(P<0.05);两组间植皮区麻木、植皮区痛觉异常差异无统计学意义(P>0.05).结论:逆行腓动脉穿支筋膜蒂皮瓣与逆行胫后动脉穿支筋膜蒂皮瓣两者均可有效修复下肢与足踝皮肤缺损,但是逆行腓动脉穿支筋膜皮瓣存活率高,并发症少,值得临床推广.%Objective To analysisthe evaluation clinical effects and complications of retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap for the re-pair of the leg and foot skin defect effect. Methods In January 2010 to January 2015,patients with leg and foot skin defect effect in our hospital administrated withperoneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle skin flap were retrospectively analyzed.Flap survival,necrosis rate, the function of the skin flap and complications were analyzed. Results The one stage flap survival rate of peroneal artery group(84.6%)is higher than the posterior tibial artery group(57.69%),the difference was statistically sig-nificant(P < 0.05). There were no significant difference between the flap function index(pain,activity limita-tion,wearing shoes,functional recovery satisfaction)score and posterior tibial artery group(P>0.05). The occur-rence of hyperplastic scar,itching,pigmentation,skin graft,numbness,skin graft abnormal pain complication rates inperoneal artery group were significantly lower than the posterior tibial artery ,and the difference was statisti-cally significance(P < 0.05). Conclusion Retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap can effectively repair skin and soft tissue defect ,retrograde peroneal artery perforators shows with higher survival rate and less complication.
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