踝关节和足部软组织缺损的处理
Management of Soft Tissue Defects of the Ankle and Foot.
作者信息
Bhandari P S, Bath A S, Sadhotra L P, Singh Manmohan, Mukherjee M K
机构信息
Classified Specialist, Surgery and Reconstructive Surgery.
Deputy Commandant, Command Hospital (NC), C/o 56 APO.
出版信息
Med J Armed Forces India. 2005 Jul;61(3):253-5. doi: 10.1016/S0377-1237(05)80167-4. Epub 2011 May 30.
BACKGROUND
Treatment of soft tissue defect of ankle and foot has always been a challenging problem.
METHODS
Thirty patients with soft tissue defects of the ankle and foot who underwent various reconstructive procedures in two tertiary care teaching hospitals were studied.
RESULTS
Most of the defects (33%) were located in and around the ankle. Trauma was the major cause (56.6%). Defects were reconstructed with a variety of local, regional, distant and microvascular free flaps. Distally based superficial sural artery flap was used in majority of the cases (40%). Free tissue transfer using radial artery forearm flap was done in three (10%) complex wounds where other flaps were not found to be suitable. Superficial soft tissue defects on the dorsum of foot were resurfaced with split thickness skin grafts in 3 (10%) cases. Out of 27 flaps used, 26 survived completely. One inferiorly based fasciocutaneous flap developed partial necrosis. There was graft loss in one patient which required regrafting with the stored autograft.
CONCLUSION
Distally based superficial sural artery flap remains the choice for reconstruction of soft tissue defects of ankle and foot because of its reliable blood supply and easy elevation.
背景
踝足部软组织缺损的治疗一直是个具有挑战性的问题。
方法
对在两家三级护理教学医院接受各种重建手术的30例踝足部软组织缺损患者进行了研究。
结果
大部分缺损（33%）位于踝关节及其周围。创伤是主要原因（56.6%）。采用多种局部、区域、远处和游离微血管皮瓣对缺损进行重建。大多数病例（40%）采用远端蒂腓肠浅动脉皮瓣。在3例（10%）其他皮瓣不合适的复杂伤口中，采用桡动脉前臂游离皮瓣进行游离组织移植。3例（10%）足部背侧浅软组织缺损采用中厚皮片移植修复。在使用的27个皮瓣中，26个完全存活。1个远端蒂筋膜皮瓣出现部分坏死。1例患者移植皮片丢失，需要用储存的自体皮片重新移植。
结论
远端蒂腓肠浅动脉皮瓣因其血供可靠、易于切取，仍然是踝足部软组织缺损重建的首选皮瓣。
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