改良腓动脉穿支螺旋桨皮瓣在足踝部皮肤软组织缺损中的修复效果
Effect of Modified Peroneal Perforator Propeller Flap in Repairing Skin and Soft Tissue Defect of Foot and Ankle
杜娇 1王毅 1郑德义 1张恺悦 1陈大志 1颜小玲1
作者信息
- 1. 贵州省人民医院 贵州 贵阳 550001
- 折叠
摘要
目的:探讨足踝部皮肤软组织缺损患者采用改良腓动脉穿支螺旋桨皮瓣修复的效果.方法:选择2019年7月—2022 年 12 月贵州省人民医院整形烧伤外科收治的 100 例足踝部皮肤软组织缺损行皮瓣修复的患者.按照随机数表法分为对照组和观察组,各 50 例,对照组予以腓动脉穿支皮瓣修复,观察组予以改良腓动脉穿支螺旋桨皮瓣修复.观察两组皮瓣情况(皮瓣一期成活率、增生性瘢痕、色素沉着发生率)、皮瓣感觉功能、踝关节活动度(踝关节跖屈、背伸角度)及踝关节功能[美国足踝外科协会(AOFAS)踝与后足评分系统评分].结果:观察组皮瓣一期成活率为 94.00%,高于对照组的80.00%,差异有统计学意义(P<0.05);两组术后增生性瘢痕、色素沉着发生率比较,差异无统计学意义(P>0.05).观察组皮瓣感觉恢复优良率为 88.00%,高于对照组的 72.00%,差异有统计学意义(P<0.05).术后 6 个月,两组踝关节跖屈、背伸角度高于术前,且观察组高于对照组,差异有统计学意义(P<0.05).术后 6 个月,两组疼痛、力线及功能维度评分高于术前,且观察组高于对照组,差异有统计学意义(P<0.05).结论:改良腓动脉穿支螺旋桨皮瓣在足踝部皮肤软组织缺损修复中血运可靠,能改善踝关节功能,促进皮瓣感觉功能恢复,提高皮瓣一期成活率.
Abstract
Objective:To investigate the effect of modified peroneal perforator propeller flap in repairing the foot and ankle skin and soft tissue defects.Method:A total of 100 cases of foot and ankle skin and soft tissue defects treated for flap repair in the Department of Plastic and Burn Surgery of Guizhou Provincial People's Hospital from July 2019 to December 2022 were selected,they were divided into control group and observation group according to random number table method,with 50 cases in each group.The control group was repaired with peroneal perforator flap,and the observation group was repaired with modified peroneal perforator propeller flap.The skin flaps status(first stage survival rate of skin flaps,incidence of hypertrophic scars and pigmentation),skin flaps sensory function,ankle joint range of motion(ankle joint plantar flexion and dorsiflexion angle),and ankle joint function[American Association of Foot and Ankle Surgery(AOFAS)ankle and posterior foot scoring system].Result:The first stage survival rate of the observation group flap was 94.00%,which was higher than the 80.00%of the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the incidence of postoperative hypertrophic scars and pigmentation between the two groups(P>0.05).The excellent rate of skin flap sensation recovery in the observation group was 88.00%,which was higher than the 72.00%in the control group,and the difference was statistically significant(P<0.05).Six months after surgery,the ankle joint plantar flexion and dorsiflexion angle in the two groups were higher than those before surgery,and the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Six months after surgery,the pain,force line,and functional dimension scores of the two groups were higher than those before surgery,and the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The modified peroneal perforator propeller flap has reliable blood supply in the repair of foot and ankle skin and soft tissue defects,which can improve ankle joint function,promote the recovery of skin flap sensory function,and increase the first stage survival rate of skin flap.
关键词
腓动脉穿支螺旋桨皮瓣/皮瓣修复/足踝部皮肤软组织缺损/踝关节功能Key words
Peroneal perforator propeller flap/Flap repair/Skin and soft tissue defect of foot and ankle/Ankle joint function引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据