旋髂浅动脉穿支游离皮瓣修复小儿足背皮肤软组织缺损
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摘要
目的:研究应用旋髂浅动脉穿支游离皮瓣修复小儿足背皮肤软组织缺损伴肌腱或骨外露创面的临床疗效。方法:回顾性分析2014年1月-2016年9月收治的13例足背部皮肤软组织缺损伴肌腱或骨外露患儿,一期清创行VSD覆盖,二期采用旋髂浅动脉穿支游离皮瓣覆盖创面,供区全部直接缝合。结果:所有患儿皮瓣全部存活,创面得到了有效修复;移植皮瓣未见明显色素沉着、无肌腱粘连,足背部外观恢复满意,下肢负重、行走功能正常;供区仅遗留线性瘢痕,部位隐蔽不易察觉。结论:对于足背部皮肤软组织缺损伴肌腱或骨外露的患儿,采用旋髂浅动脉穿支游离皮瓣移植修复,疗效可靠,是理想的治疗方法。
Objective To discusss the clinical application of using the superficial circumflex iliac artery perforator flaps in treating skin and soft tissue defects of foot back in children. Methods From January 2014 to September 2016, 13 children(10 boys,3 girls) underwent transplantation of superficial circumflex iliac artery perforator flap were retrospectively reviewed. Initial debridement and vacuum sealing drainage(VSD)coverage were followed by flap covering if the wounds did not infeeted after several days. All of the donor site underwent direct suture. Results All of the cases had good coverage of the wounds and flaps survival.AlI of the cases were followed up from 1 to 12 months.The appearance of the recipient site is good without obvious scar in all cases.the function of the foots were excellent without tendon adhesion.The donor skin heals well with linear scar.Conclusion The superficial circumflex iliac artery perforator free flaps is effective to repair skin and soft tissue defects associated with bone or tendon exposure of foot back in children. which is a good method.
Objective To discusss the clinical application of using the superficial circumflex iliac artery perforator flaps in treating skin and soft tissue defects of foot back in children. Methods From January 2014 to September 2016, 13 children(10 boys,3 girls) underwent transplantation of superficial circumflex iliac artery perforator flap were retrospectively reviewed. Initial debridement and vacuum sealing drainage(VSD)coverage were followed by flap covering if the wounds did not infeeted after several days. All of the donor site underwent direct suture. Results All of the cases had good coverage of the wounds and flaps survival.AlI of the cases were followed up from 1 to 12 months.The appearance of the recipient site is good without obvious scar in all cases.the function of the foots were excellent without tendon adhesion.The donor skin heals well with linear scar.Conclusion The superficial circumflex iliac artery perforator free flaps is effective to repair skin and soft tissue defects associated with bone or tendon exposure of foot back in children. which is a good method.
引文
[1]周晓,薛明宇,芮永军,等.以小腿后侧穿支蒂接力皮瓣修复跟后区皮肤软组织缺损[J].中华医学杂志,2015,95(7):544-546.
[2]黄凯,郭峭峰,林炳远,等.负压封闭引流联合游离股前外侧皮瓣治疗小儿足踝部软组织缺损[J].中华整形外科杂志,2016,32(3):225-226.
[3]Goh TL,Park SW,Cho JY,et a1.The search for the ideal thin skin flap:superficial circumflex iliac artery perforator flap-A review of 210cases[J].Plast Reconstr Surg,2015,135(2):592-601.
[4]万强,赵云珍,何贤标,等.带双套血供的外踝上皮瓣修复足背皮肤缺损的临床应用[J].中华显微外科杂志,2016,39(2):172-174.
[5]刘承伟,刘福尧,邱冰,等.切取阔筋膜的股前外侧皮瓣在足踝皮肤肌腱缺损中的应用[J].中华显微外科杂志,2015,38(4):382-383.
[6]傅跃先,向代理,邱林,等.儿童隐动脉皮瓣交腿移植10例[J].中华整形外科杂志,1999,15(4):316.
[7]文根,吴旭华,柴益民,等.股前外侧皮瓣供区并发症的分析[J].中国修复重建外科杂志,2009,23(10):1177-1179.
[8]顾玉东.皮瓣移植修复创面的发展及临床应用原则[J].中华移植杂志(电子版),2011,5(1):5-6.
[9]Koshima I,Nanba Y,Tsutsui T,et a1.Superficial circumflex iliac artery perforator flap for reconstruction of limb defects[J].Plast Reconstr Surg,2004,113(1):233-240.
[10]Hsu WM,Chao WN,Yang C,et a1.Evolution of the free groin flap:the superficial circumflex iliac artery perforator flap[J].Plast Reconstr Surg,2007,119(5):1491-1498.
[11]Feng S,Xi W,Zhang Z,et a1.A reappraisal of the surgical planning of the superficial circumflex iliac artery perforator flap[J].J Plast Reconstr Aesthet Surg,2017,70(4):469-477.
[12]梁晓宗,萧志雄,尤庆国,等.游离髂腹股沟皮瓣修复足踝部组织缺损18例[J].中华显微外科杂志,2017,40(2):176-178.
[13]庄加川,张振伟,李征,等.穿支皮瓣血管吻合方式改良的临床应用[J].中华手外科杂志,2016,32(1):77-78.
[2]黄凯,郭峭峰,林炳远,等.负压封闭引流联合游离股前外侧皮瓣治疗小儿足踝部软组织缺损[J].中华整形外科杂志,2016,32(3):225-226.
[3]Goh TL,Park SW,Cho JY,et a1.The search for the ideal thin skin flap:superficial circumflex iliac artery perforator flap-A review of 210cases[J].Plast Reconstr Surg,2015,135(2):592-601.
[4]万强,赵云珍,何贤标,等.带双套血供的外踝上皮瓣修复足背皮肤缺损的临床应用[J].中华显微外科杂志,2016,39(2):172-174.
[5]刘承伟,刘福尧,邱冰,等.切取阔筋膜的股前外侧皮瓣在足踝皮肤肌腱缺损中的应用[J].中华显微外科杂志,2015,38(4):382-383.
[6]傅跃先,向代理,邱林,等.儿童隐动脉皮瓣交腿移植10例[J].中华整形外科杂志,1999,15(4):316.
[7]文根,吴旭华,柴益民,等.股前外侧皮瓣供区并发症的分析[J].中国修复重建外科杂志,2009,23(10):1177-1179.
[8]顾玉东.皮瓣移植修复创面的发展及临床应用原则[J].中华移植杂志(电子版),2011,5(1):5-6.
[9]Koshima I,Nanba Y,Tsutsui T,et a1.Superficial circumflex iliac artery perforator flap for reconstruction of limb defects[J].Plast Reconstr Surg,2004,113(1):233-240.
[10]Hsu WM,Chao WN,Yang C,et a1.Evolution of the free groin flap:the superficial circumflex iliac artery perforator flap[J].Plast Reconstr Surg,2007,119(5):1491-1498.
[11]Feng S,Xi W,Zhang Z,et a1.A reappraisal of the surgical planning of the superficial circumflex iliac artery perforator flap[J].J Plast Reconstr Aesthet Surg,2017,70(4):469-477.
[12]梁晓宗,萧志雄,尤庆国,等.游离髂腹股沟皮瓣修复足踝部组织缺损18例[J].中华显微外科杂志,2017,40(2):176-178.
[13]庄加川,张振伟,李征,等.穿支皮瓣血管吻合方式改良的临床应用[J].中华手外科杂志,2016,32(1):77-78.