论文部分内容阅读
目的探讨应用足底内侧动脉皮瓣修复足跟、前足底电烧伤创面的手术方法及临床效果。方法 2010年1月至2015年5月收治足跟、前足底电烧伤患者21例,其中足跟部12例,前足底9例;创面均骨质外露或肌腱外露。患足术前均用超声多普勒血流探测仪探测血管蒂部位及走行的方向,并标记。手术采取腰硬联合麻醉,供瓣区全厚皮植皮,下腹部取皮;采用足底内侧动脉皮瓣修复足跟缺损和前足底缺损。结果术后所有皮瓣全部成活,仅2例皮瓣远端出现坏死,经换药后愈合。随访6~12个月,皮瓣外形满意,质韧耐磨,足跟及前足底无破溃现象,感觉良好,两点辨别觉8~12 mm,足及足趾活动功能良好。结论足底内侧动脉皮瓣切取方便,血供可靠,厚薄适中,外形佳,是修复足跟、前足底电烧伤创面的理想选择。
Objective To investigate the surgical method and clinical effect of repairing heel and forefoot electric burn wounds by using the medial plantar artery flaps. Methods From January 2010 to May 2015, 21 cases of heel and anterior sole burn were treated, including 12 cases of heel and 9 cases of anterior sole. The wounds were exposed with bone or tendon. Preoperative patients with ultrasound Doppler ultrasonic blood flow detector to detect the location of the pedicle and the direction of travel, and marked. Surgical operation of combined spinal and epidural anesthesia for the full thickness of skin flap skin graft, the lower abdomen to take the skin; the use of the medial plantar artery flap to repair heel defects and anterior defect. Results All the flaps survived after operation, and only 2 cases of distal necrosis of skin flap healed after dressing change. The follow-up ranged from 6 to 12 months. The skin flap was satisfactory in shape, tough in quality and wearable. There was no ulceration on the heel and forefoot, and the feeling was good. Conclusions The medial basilar artery flaps are easy to cut, reliable blood supply, moderate thickness and good appearance, which are ideal for repairing electric burn wounds on the heel and forefoot.