Department of Orthopaedic Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Hubei Clinical Medical Research Center of Trauma Microsurgery, Wuhan, China.
Orthop Surg. 2024 Dec;16(12):3179-3184. doi: 10.1111/os.14265. Epub 2024 Oct 16.
The failure rate of foot and ankle soft tissue defect reconstruction with flap is relatively high, often posing a significant burden on patients. The aim of this study is to explore the effectiveness of repeated stretch sutures in repairing skin and soft tissue defects of the ankle and foot.
Twenty-three patients with ankle and foot skin and soft tissue defects were retrospectively analyzed between February 2016 and February 2019. Sutures were repeatedly stretched every 3-5 days. Local skin grafting was performed if necessary after wound surfaces disappeared or exposed tendons and bones were covered by soft tissue. Wound healing time, postoperative healing area, Vancouver Scar Assessment Scale, sensation, and function of the new skin were evaluated.
Healing time was 17-35 (24.43 ± 5.29) days. Ten patients wholly healed, and 13 healed by approximately 70.08% ± 6.59%. The Vancouver Scar Assessment Scale average score was 2.83 ± 1.19 points, of which 15 cases were excellent (0-3 points) and 8 cases were good (4-7 points). The sensation and function of the new skin after repair were equivalent to those of normal skin after the last follow-up.
Applying repeated tension sutures on the skin and soft defects of the ankle and foot reduced the skin graft area and decreased complex high-risk surgical flaps' use and transplantation area.
足部和踝关节软组织缺损皮瓣重建的失败率相对较高，往往给患者带来很大负担。本研究旨在探讨重复拉伸缝合在修复踝关节和足部皮肤软组织缺损中的效果。
回顾性分析 2016 年 2 月至 2019 年 2 月 23 例踝关节和足部皮肤软组织缺损患者的临床资料。每隔 3-5 天重复拉伸缝合线。当创面消失或肌腱和骨骼被软组织覆盖时，必要时进行局部植皮。评估伤口愈合时间、术后愈合面积、温哥华瘢痕评估量表、新皮肤的感觉和功能。
愈合时间为 17-35（24.43±5.29）天。10 例患者完全愈合，13 例患者愈合约 70.08%±6.59%。温哥华瘢痕评估量表平均得分为 2.83±1.19 分，其中 15 例为优（0-3 分），8 例为良（4-7 分）。末次随访时，修复后新皮肤的感觉和功能与正常皮肤相当。
在踝关节和足部皮肤软组织缺损处应用重复张力缝合线，减少了植皮面积，降低了复杂高危手术皮瓣的使用和移植面积。
