Chung Benjamin, Wong Manzhi, Ch'ng Jack Kian
Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore.
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore.
J Plast Reconstr Surg. 2024 Feb 16;3(3):110-114. doi: 10.53045/jprs.2023-0023. eCollection 2024 Jul 27.
Ray amputation wounds caused by diabetic foot gangrene are often left to heal by secondary intention. They can be large and take a prolonged time to heal, exposing patients to complications and risk of recurrent infection. A 77-year-old male with diabetes and peripheral vascular disease presented to our institution with left 2nd-5th toe gangrene. He underwent a successful left lower limb angioplasty with good flow to the digital arteries. Left 2nd-5th toe ray amputation was performed, with the excess viable skin of the left second toe preserved as a digital fillet flap for wound coverage. The patient was discharged on postoperative day 1. Healing was complicated by a stitch sinus, but the wound completely healed with good epithelialization at 4 months postoperatively. This case report demonstrates the utility of the toe fillet flap in the coverage of ray amputation wounds in patients with diabetes and peripheral vascular disease.
糖尿病足坏疽导致的截趾伤口通常任其通过二期愈合。这些伤口可能很大，愈合时间长，使患者面临并发症和反复感染的风险。一名患有糖尿病和外周血管疾病的77岁男性因左足第2至第5趾坏疽前来我院就诊。他接受了成功的左下肢血管成形术，趾动脉血流良好。进行了左足第2至第5趾截趾术，保留左第二趾多余的存活皮肤作为趾条皮瓣用于覆盖伤口。患者术后第1天出院。愈合过程因缝线窦道而复杂化，但伤口在术后4个月完全愈合，上皮化良好。本病例报告展示了趾条皮瓣在糖尿病和外周血管疾病患者截趾伤口覆盖中的应用价值。
