探讨腓肠神经营养血管皮瓣临床应用和改良.docVIP

探讨腓肠神经营养血管皮瓣临床应用和改良 　　[摘要]目的 探讨腓肠神经营养血管逆行皮瓣的临床应用，并对手术方法进行归纳、总结、改良，进一步提高皮瓣的成活率。方法 选取2015年2月～2017年1月我院收治的60例临床创伤致前足背皮肤组织缺损患者，按照手术方法的不同分为观察组和对照组，每组30例。观察组应用改良腓肠神经营养血管皮瓣修复方法，对照组应用传统腓肠神经营养血管皮瓣修复方法，观察两组的临床疗效、创面愈合时间及并发症发生情况。结果 观察组的治疗总有效率为100.0%，高于对照组的86.7%，差异有统计学意义（P0.05）。观察组的创面愈合时间显著短于对照组，差异有统计学意义（P0.05）。观察组的并发症发生率为0.0%，低于对照组的16.7%，差异有统计学意义（P0.05）。结论 腓肠神经营养血管皮瓣是修复前足背皮肤组织缺损伴肌腱、骨头、血管外露的理想方法，通过改良手术方法，更有利于皮瓣成活，恢复效果良好。 　　[关键词]腓肠神经；外科皮瓣；修复手术；皮肤组织缺损 　　[中图分类号] R658.2 [文献标识码] A [文章编号] 1674-4721（2017）12（a）-0019-04 　　[Abstract]Objective To explore the clinical application of sural neurovascular retrograde flap，to summarize and improve the surgical method，and to further improve the survival of the flap.Methods 60 cases of forefoot skin tissue defect caused by trauma from February 2015 to January 2017 in our hospital were selected as the subjects，according to the different surgical methods，all patients were divided into the observation group and the control group，30 cases in each group.The observation group was used modified sural neurovascular nutrition flap repair method，the control group was used traditional sural neurovascular nutrition flap repair method.The clinical efficacy，wound healing time and complications occurred were observed between the two groups.Results The total effective rate of the observation group was 100.0%，which was higher than 86.7% of the control group，the difference was statistically significant （P0.05）.The wound healing time of the observation group was significantly lower than that in the control group，with significant difference （P0.05）.The incidence of complications of the observation group was 0.0%，which was lower than 16.7% of the control group，the difference was statistically significant （P0.05）.Conclusion The sural neurovascular nutrition flap is an ideal method for repairing the defects of the forefoot skin tissue defect with the tendon，bone and blood vessels，it is more beneficial to the survival of the flap and improve the recovery effect thro