游离腓肠内侧动脉穿支皮瓣修复前足软组织缺损
Repair of soft tissue defect of forefoot with free medial sural artery perforator flap
周兴 1朱自强 1谢久虎 1郝宝辉 1黄立1
作者信息
- 1. 徐州医科大学第二附属医院手外科,江苏徐州 221000
- 折叠
摘要
目的 探讨应用游离腓肠内侧动脉穿支皮瓣(MSAP)修复前足软组织缺损的临床疗效.方法 2019年5月-2022年5月,应用腓肠内侧动脉穿支皮瓣修复前足软组织缺损11例.一期行VSD覆盖,二期均行MSAP修复创面,皮瓣切取面积4.0 cm×7.0 cm～7.0 cm×10.0cm.术后2周观察皮瓣成活情况,术后1个月、2个月、3个月、6个月及末次随访观察皮瓣外观、感觉、供区恢复及并发症发生情况.根据曼彻斯特-牛津足部调查问卷(MOXFQ)评价治疗效果.结果 11例MSAP均成活,1例出现静脉危象,探查后皮瓣成活.随访时间6～9个月,平均7个月,皮瓣外观良好,质地柔软,穿鞋满意,2例因皮瓣臃肿行皮瓣修整.5例感觉恢复至S3级,5例感觉恢复至S2级,1例感觉恢复至S1级.供区均直接缝合,伤口仅留线性瘢痕,无功能影响.结论 MSAP皮下脂肪薄,毛发少,外形美观,穿支较恒定,血管蒂长,供区可直接缝合,是修复前足软组织缺损较好的手术方式.
Abstract
Objective To investigate the clinical effect of free medial sural artery perforator flap(MSAP)for repairing forefoot soft tissue defect.Methods From May 2019 to May 2022,11 patients with the soft tissue defect of forefoot were treated with medial sural artery perforator flap.VSD treatment was performed in the first phase,and MSAP was performed in the second phase to repair the wound.The flap area was 4.0 cm × 7.0 cm～7.0 cm × 10.0 cm.The survival of the flap was observed within 2 weeks after the operation,and the appearance,feeling,donor area recovery and complications of the flap were observed 1,2,3,6 months after surgery and at the last follow-up.The treatment effect was evaluated according to the Manchester-Oxford Foot Questionnaire(MOXFQ).Results All 11 cases survived.One flap with venous crisis survived after exploration.The follow-up time was 6 to 9 months,with an average of 7 months.The flaps showed good appearance,soft texture,and satisfactory shoes.Two patients showed swollen and underwent flap revision.Five flaps recovered to grade S3,five flaps recovered to grade S2,one case recovered to grade S1.The donor sites were directly sutured,and a linear scar remained at the donor sites without functional impact.Conclusion The free medial sural artery perforator flap(MSAP)has thin subcutaneous fat,a relatively less hair,beautiful appearance,relatively constant perforating branches,long vascular pedicle,and can be sutured directly at the donor site.MSAP is a good flap for repairing the soft tissue defect of the forefoot.
关键词
腓肠内侧动脉穿支皮瓣/修复/前足/软组织损伤Key words
Medial sural artery perforator flap/Repair/Forefoot/Soft tissue injury引用本文复制引用
出版年
2024
NETL
NSTL
万方数据