- 期刊
The Versatility of Distally Based Sural Flap for Reconstruction of Lower Leg and Foot
以遠端腓腸皮瓣做下肢重建之多樣化應用
摘要
對於下肢遠端及足部之軟組織覆蓋是個困難的工作，遠端性腓腸皮瓣有較長血源蒂可提供，外觀及功能上需要。本院共有27例病患使用此皮瓣，20例男性，7例女性。其病因包括慢性潰瘍、創傷、開放性骨折、燒傷，血管瘤、黑色素瘤，以部位分佈而言，在前經部6例，在韌帶部6例，在足跟部6例，在內踝部4例，在足部3例，在外踝部2例。血源蒂經過隧道到缺損區有18例，血源蒂需植皮有7例。兩例血源蒂接受先形成管狀皮瓣再分離皮瓣。皮瓣大小由3×5至6×12公分。供給區直接縫合有20例，植皮有7例，有3例皮瓣完全失敗，兩例遠皮瓣端壞死。這些併發症全發生在糖尿病患者，故對糖尿病患者血糖控制及分皮瓣必須更加小心處理。我們認為這是個穩定容易執行皮瓣，對下肢及足部小至中等傷口，具有多樣性及低供給區問題，為下肢重建另一不錯的選擇。
關鍵字
無資料並列摘要
The coverage of the soft-tissue on the lower third of the leg has always been a difficult problem to tackle. Distally based sural flap with a long pedicle can meet the patient's aesthetic and functional needs of reconstruction. We had used this flap on twenty-seven patients. Of these, twenty were males and seven were females. The flap reconstruction was used in such situations as chronic ulcer, trauma, open fracture, burn, hemangioma, and melanoma. There were six cases of defect located in the anterior tibia, six in Achilles tendon, six in heel, four in medial malleolus, two in lateral malleolus, and three in foot. The pedicle was passed through a tunnel to the defect in eighteen cases and skin graft was used in seven cases. Two patients received tubular flap coverage and division of pedicle two weeks later. The size of the flap was varied from 3×5 to 6×12 cm. There were twenty cases in the donor site with primary closure. Seven cases had skin graft. There were three cases that resulted in total failure and two cases that resulted in partial necrosis in the flap. Most of these complications had occurred in the diabetic patients. Regular blood sugar control and delicate harvest of the flap were requested. This series had demonstrated that a distally based sural flap provided a reliable and easy practical modality, as well as versatility and low donor-site morbidity, for reconstruction of small to medium defects of the lower limb.
延伸閱讀
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