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目的探讨应用穿支皮瓣修复足踝部烧伤创面的方法及其效果。方法应用4种穿支皮瓣:腓动脉外踝上前穿支皮瓣、腓动脉外踝上后穿支皮瓣、胫后动脉内踝上穿支皮瓣、第一跖背动脉远端穿支皮瓣,根据需要选取不同的皮瓣转移修复足踝部烧伤创面。结果本组共15例,其中腓动脉外踝上前穿支皮瓣,即外踝上筋膜皮瓣4例;腓动脉外踝上后穿支皮瓣,即腓肠神经营养血管筋膜皮瓣6例;胫后动脉内踝上穿支皮瓣,即内踝上筋膜皮瓣3例;第一跖背动脉远端穿支皮瓣2例。本组患者移位皮瓣全部成活,切口一期愈合。随访1～24个月,皮瓣色泽、质地好,足踝部及供区外形及功能恢复良好。结论应用选取邻近的穿支皮瓣修复足踝部烧伤创面具有不牺牲胫后动脉、腓动脉等主要血管,对足部的血供与功能无明显影响;供区损害少,不破坏供区外形与功能;皮肤质地好,皮下脂肪少,弹性及皮色与足部近似;不需要吻合血管,手术操作相对简单,成活率高。
Objective To investigate the method and effect of perforator flap for the repair of burn wounds in the foot and ankle. Methods Four kinds of perforator flaps were used: the anterior superior perforator flap of the peroneal artery, the posterior perforator flap of the peroneal artery, the perforator flap of the medial malleolus of the posterior tibial artery, the distal perforator flap of the first dorsal metatarsal artery According to the need to choose a different flap transfer repair ankle burn wounds. Results The group of 15 cases, including the peroneal artery peroneal anterior wear perforating branch flap, the lateral malleolus fascia flap in 4 cases; peroneal artery posterior malleolus perforating branch flap, that is, sural nerve nutrition vascular fascia flap in 6 cases ; Posterior tibial artery medial malleolus perforator flap, that is, the medial malleolus fascia flap in 3 cases; the first dorsal metatarsal distal perforating branch flap in 2 cases. All patients in this group of displaced flap survival, incision healed. Follow-up 1 ~ 24 months, flap color, texture, foot and ankle and donor area shape and function recovered well. Conclusions The application of the adjacent perforator flap for the repair of burn wounds in the foot and ankle has no significant effects on the blood supply and function of the foot without sacrificing the main blood vessels such as the posterior tibial artery and the peroneal artery. Function; good skin texture, less subcutaneous fat, elasticity and skin color and foot similar; do not need to meet the blood vessels, the operation is relatively simple, high survival rate.