Zhou Jian, Chang Shusen, Deng Chengliang, Huang Guangtao, Jin Wenhu, Chen Wei, Wei Zairong
Department of Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Front Surg. 2023 Jan 6;9:815125. doi: 10.3389/fsurg.2022.815125. eCollection 2022.
A 36-year-old healthy male patient was presented to the emergency room 3 h after experiencing a laceration to the left foot caused by a porcelain shard. The defect measured 7.5 × 6.0 × 0.8 cm, and the composite amputated tissue consisted of skin and subcutaneous layers. The terminal branch of the lateral calcaneal artery was first anastomosed end-to-end to the corresponding artery in the wound defect. The lateral calcaneal nerve was anastomosed after blood flow was restored. The two lateral veins were anastomosed end-to-end to the corresponding veins in the wound defect. Postoperatively, 1.0 × 1.5 cm area of skin necrosis was present at the distal end of the tissue, which healed smoothly after two weeks of dressing changes. The patient had retained excellent aesthetic and functionality by the 37 month follow up. Although such isolated amputation is relatively rare, microsurgical replantation is, thus, a feasible option in the management of heel amputation.
一名36岁的健康男性患者，在左脚被瓷片割伤3小时后被送往急诊室。缺损尺寸为7.5×6.0×0.8厘米，离断的复合组织包括皮肤和皮下层。首先将跟外侧动脉的终末分支与伤口缺损处的相应动脉进行端端吻合。在恢复血流后吻合跟外侧神经。将两条外侧静脉与伤口缺损处的相应静脉进行端端吻合。术后，组织远端出现1.0×1.5厘米的皮肤坏死区域，经过两周换药后顺利愈合。到37个月随访时，患者保留了极佳的美观度和功能。尽管这种孤立性断肢相对少见，但显微外科再植术仍是足跟断肢治疗中的一种可行选择。
