带胫后动脉蒂逆行岛状皮瓣急诊一期修复足跟部软组织缺损13例.docVIP

带胫后动脉蒂逆行岛状皮瓣急诊一期修复足跟部软组织缺损13例摘要目的回顾分析应用带胫后动脉蒂逆行岛状皮瓣急诊一期修复足跟部软组织缺损的疗效，以探讨足跟部软组织缺损的有效治疗方法。方法经临床应用带胫后动脉蒂逆行岛状皮瓣急诊一期修复13例足跟部软组织缺损患者，供区应用单纯游离植皮修复伤口，术后应用“三抗”治疗。结果13例足跟部软组织缺损患者术后伤口愈合和功能全部达到优良，经随访1～18个月，结果全部恢复自由行走功能，无麻木和行走痛等并发症。结论应用带胫后动脉蒂逆行岛状皮瓣是急诊一期修复足跟部软组织缺损的一种有效的治疗方法。 关键词：血管蒂 皮瓣 移植 软组织缺损 [ Abstract ] ]Objective: After the review analysis application belt shin the artery peduncle goes against the flow an island shape skin petal emergency medical treatment issue of repair heel department soft tissue damage curative effect, by discusses the heel department soft tissue damage the effective method of treatment.Methods: The artery peduncle goes against the flow an island shape skin petal emergency medical treatment issue after the clinical practice belt shin to repair 13 examples heels department soft tissue damage patient, purely drifts away for the area application to graft skin the repair wound, after the technique applies “three anti-” the treatment. Results:After 13 examples heels department soft tissue damage patient technique the wound heals with the function achieves completely finely, after makes a follow-up visit for 1 - 18 months, the result restores completely freely walks the function, does not have numb and walks illness complication and so on pain. Conclusion: The artery peduncle goes against the flow island shape Pi Ban after the belt shin is an emergency medical treatment issue of repair heel department soft tissue damage one effective method of treatment. [ Key word ] blood vessel Tippy petal transplantsoft tissue damage 足跟部损伤常常是由自行车或摩托车后轮卷伤所致，是临床上经常遇到的一类特殊类型的损伤，由于足跟部软组织少，局部损伤后容易导致皮肤软组织缺损，肌腱、神经、血管和骨外露，其在急诊早期处理极为重要，稍有不慎，易产生不良后果。我科自1999年以来采用同侧带胫后动脉蒂逆行岛状皮瓣急诊一期修复足跟部软组织缺损13例，取得满意疗效。 1.资料与方法 1.1一般资料：本组13例中男9例，女4例。年龄6～52岁，平均34岁。其中摩托车后轮卷伤8例，自行车后轮卷伤3例，重物砸伤2例。左下肢4例，右下肢9例，合并跟骨骨折5例，内踝骨折3例。入院时间最短40分钟，最长6小时，平均2小时。经清创后皮肤软组织不同程度缺损，面积最大14 cm×10cm，最小6 cm×5 cm.。同时行骨折内固定7例。 1.2手术方法：(1)彻底清创：在止血带控制下彻底清洗伤口，消毒术野皮肤，铺巾。剪除失去活力和污染组织；(2) 对合并骨折者先行骨折复位内固定：大部分内、外踝、跟骨、跗骨骨折