目的 比较携带穿支的 V-Y 推移皮瓣与穿支蒂螺旋桨皮瓣在修复小腿软组织缺损方面的疗效.方法 回顾分析 2019 年 9 月至 2022 年 12 月收治的小腿皮肤软组织缺损 20 例患者的临床资料,根据治疗方法分为两组,A 组采用携带穿支的改良 V-Y 推移皮瓣覆盖创面,B 组采用经典的穿支蒂螺旋桨皮瓣覆盖创面.术后随访 6～12 个月,比较两组的手术时间、术中出血量、切口总长度、术后皮瓣愈合时间、皮瓣存活率、术后并发症发生率.结果 A 组的皮瓣存活率为 100%,B 组的皮瓣存活率为 90%,差异无统计学意义(P>0.05);A 组手术时间、术中出血量、皮瓣愈合时间及切口总长度均优于 B 组,差异有统计学意义(P<0.05);A 组并发症发生率(10%)明显低于 B 组(100%),差异有统计学意义(P<0.05).结论 当小腿皮肤软组织缺损直径 5 cm 左右时,V-Y 推移皮瓣修复皮肤缺损优于穿支蒂螺旋桨皮瓣,具有血供可靠、不浪费皮瓣、瘢痕短等优势.
Comparative analysis of the V-Y advancement flap and pedicled perforator island propeller flap of the lower leg in repairing composite tissue defects of lower limbs
Objective To compare the curative effects between V-Y advancement flap based on perforators and pedicled perforator island in repairing tissue defect of lower limbs.Methods The clinical data of 20 patients with skin and soft defects of lower limbs from September 2019 to December 2022 were analyzed retrospectively.All the patients were divided into group A and group B randomly.The defects were repaired with V-Y advancement flaps based on perforators in group A,while with pedicled perforator island propeller flap in group B.All patients were followed up from 6 months to 12 months after operation.The operative time,intraoperative blood loss,total incision length,flap healing time,flap survival rates and incidence rates of postoperative complications were compared between the two groups.Results The flap survival rate was 100%in group A and 90%in group B.The operative time,intraoperative blood loss,flap healing time and total incision length in group A were shorter than that in group B,and the differences were statistically significant(P<0.05).The incidence rate of postoperative complications was 10%in group A and 100%in group B,with statistically significant differences between the two groups(P<0.005).Conclusions When the soft tissue defect is about 5cm,the V-Y advancement flap was more effective than the pedicle perforator island propeller flap of the lower leg in repairing composite tissue defects of lower limbs.V-Y advancement flap can provide excellent matching texture and a convenient primary closure of the donor site.
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