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十三年随访:逆行腓肠神经营养血管皮瓣修复跟骨足底创面一例报告

Thirteen-Year Follow-Up Reverse Sural Artery Flap for Plantar Calcaneal Wound: A Case Report.

作者信息

Donegan Ryan, Blume Peter A

机构信息

Resident Surgeon, Yale New Haven Hospital, New Haven, CT.

Assistant Professor, Department of Surgery, Anesthesia and Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT.

出版信息

J Foot Ankle Surg. 2018 Jul-Aug;57(4):833-837. doi: 10.1053/j.jfas.2017.11.018. Epub 2018 Apr 6.

Abstract

Reconstruction of soft tissue defects in the lower leg and foot after traumatic injury is a challenging problem owing to lack of locally reliable flaps. The traditional options for wound coverage often do not provide feasible or adequate treatment for many of these wounds. The lack of skin laxity in the lower leg and foot often make local flaps unavailable. Split-thickness skin grafts will not be robust enough. Free tissue flaps have a litany of potential complications and guaranteed comorbidities. The present case reinforces that appropriately selected patients with significant open bony and soft tissue trauma to the foot and ankle can be treated with a reverse sural artery fasciocutaneous flap. The reverse sural artery flap allows for full-thickness skin coverage with its own blood supply, maximizing the healing potential and should be considered a viable first option for soft tissue coverage.

摘要

由于缺乏可靠的局部皮瓣,创伤后小腿和足部软组织缺损的重建是一个具有挑战性的问题。传统的伤口覆盖方法往往无法为许多此类伤口提供可行或充分的治疗。小腿和足部皮肤松弛度不足常常导致无法采用局部皮瓣。断层皮片移植不够强健。游离组织皮瓣有一系列潜在并发症和必然的合并症。本病例再次证明,对于足部和踝部有严重开放性骨和软组织创伤且选择合适的患者,可采用逆行腓肠神经营养血管皮瓣进行治疗。逆行腓肠神经营养血管皮瓣可利用自身血供实现全层皮肤覆盖,最大限度地提高愈合潜力,应被视为软组织覆盖的可行首选方案。

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