营养皮瓣方案对足踝部软组织缺损患者术后踝关节功能及并发症的影响(1)
【摘要】 目的：探讨营养皮瓣方案对足踝部软组织缺损患者术后踝关节功能及并发症的影响。方法：选取笔者所在医院2017年5月-2018年10月收治的足踝部软组织缺损患者共104例，随机分为对照组(51例)和观察组(53例)，分别采用常规游离植皮+真空密闭引流(VSD)和营养皮瓣方案治疗，比较两组术后踝关节功能评分和术后并发症发生率。结果：观察组术后踝关节功能评分显著高于对照组[(86.33±4.10)分vs (94.07±4.93)分]，差异有统计学意义(P<0.05);观察组皮瓣坏死、皮瓣臃肿及创面感染发生率(3.77% vs 19.60%、9.43% vs 37.25%、11.32% vs 43.14%)均显著低于对照组(P<0.05)。结论：营养皮瓣方案辅助治疗足踝部软组织缺损可有效改善踝关节功能，降低皮瓣坏死、皮瓣臃肿及创面感染发生风险。
【关键词】 营养皮瓣; 真空密闭引流; 足踝部软组织缺损; 踝关节功能; 并发症
doi：10.14033/j.cnki.cfmr.2019.26.070 文献标识码 B 文章编号 1674-6805(2019)26-0-03
Effect of Nutrient Skin Flap on Ankle Function and Complications after Operation in Patients with Soft Tissue Defect of the Foot and Ankle/LAN Wentao，FU Lihua.//Chinese and Foreign Medical Research，2019，17(26)：-159
【Abstract】 Objective：To investigate the effect of nutritional skin flap on ankle function and complications in patients with soft tissue defect of the foot and ankle.Method：A total of 104 soft tissue defect of the foot and ankle from May 2017 to October 2018 were selected.They were randomly divided into the control group(51 cases) and the observation group(53 cases)，Conventional free skin grafting combined with VSD and nutritional skin flap were used for treatment，respectively.Postoperative ankle function score and postoperative complication rate were compared between the two groups.Result：Postoperative ankle function score of the observation group was significantly higher than that of the control group[(86.33±4.10)points vs (94.07±4.93)points]，the difference was significant(P<0.05).Incidence of skin flap necrosis，skin flap bloat and wound infection in the observation group were significantly lower than those in the control group(3.77% vs 19.60%，9.43% vs 37.25%，11.32% vs 43.14%)，the differences were significant(P<0.05).Conclusion：Nutrient skin flap in assisted treatment of soft tissue defects of the foot and ankle can effectively improve ankle joint function and reduce the risk of skin flap necrosis， skin flap bloat and wound infection.
【Key words】 Nutrition skin flap; VSD; Soft tissue defect of the ankle; Ankle function; Complications
First-author’s address：Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine，Fuzhou 350011，China
足踝部軟组织因较为脆弱，在外力冲击下极易出现缺损，进而导致骨外露和肌腱损伤;如未及时处理，患者创面继发感染，经软组织薄弱屏障侵袭深部，临床治疗难度极大[1]。以往对于足踝部软组织缺损患者多采用游离植皮术，但存在术后踝关节恢复效果欠佳、并发症多等问题，难以满足临床需要[2];近年来营养皮瓣+真空密闭引流(VSD)方案开始被逐渐用于足踝部软组织缺损临床治疗，并在提高移植瓣存活、提高移植效果及加快组织愈合方面显现出一定优势[3]。本文旨在探讨营养皮瓣方案对足踝部软组织缺损患者术后踝关节功能及并发症的影响，为该方案应用积累更多循证医学证据，现报道如下。, http://www.100md.com(蓝文涛 扶立华)
【关键词】 营养皮瓣; 真空密闭引流; 足踝部软组织缺损; 踝关节功能; 并发症
doi：10.14033/j.cnki.cfmr.2019.26.070 文献标识码 B 文章编号 1674-6805(2019)26-0-03
Effect of Nutrient Skin Flap on Ankle Function and Complications after Operation in Patients with Soft Tissue Defect of the Foot and Ankle/LAN Wentao，FU Lihua.//Chinese and Foreign Medical Research，2019，17(26)：-159
【Abstract】 Objective：To investigate the effect of nutritional skin flap on ankle function and complications in patients with soft tissue defect of the foot and ankle.Method：A total of 104 soft tissue defect of the foot and ankle from May 2017 to October 2018 were selected.They were randomly divided into the control group(51 cases) and the observation group(53 cases)，Conventional free skin grafting combined with VSD and nutritional skin flap were used for treatment，respectively.Postoperative ankle function score and postoperative complication rate were compared between the two groups.Result：Postoperative ankle function score of the observation group was significantly higher than that of the control group[(86.33±4.10)points vs (94.07±4.93)points]，the difference was significant(P<0.05).Incidence of skin flap necrosis，skin flap bloat and wound infection in the observation group were significantly lower than those in the control group(3.77% vs 19.60%，9.43% vs 37.25%，11.32% vs 43.14%)，the differences were significant(P<0.05).Conclusion：Nutrient skin flap in assisted treatment of soft tissue defects of the foot and ankle can effectively improve ankle joint function and reduce the risk of skin flap necrosis， skin flap bloat and wound infection.
【Key words】 Nutrition skin flap; VSD; Soft tissue defect of the ankle; Ankle function; Complications
First-author’s address：Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine，Fuzhou 350011，China
足踝部軟组织因较为脆弱，在外力冲击下极易出现缺损，进而导致骨外露和肌腱损伤;如未及时处理，患者创面继发感染，经软组织薄弱屏障侵袭深部，临床治疗难度极大[1]。以往对于足踝部软组织缺损患者多采用游离植皮术，但存在术后踝关节恢复效果欠佳、并发症多等问题，难以满足临床需要[2];近年来营养皮瓣+真空密闭引流(VSD)方案开始被逐渐用于足踝部软组织缺损临床治疗，并在提高移植瓣存活、提高移植效果及加快组织愈合方面显现出一定优势[3]。本文旨在探讨营养皮瓣方案对足踝部软组织缺损患者术后踝关节功能及并发症的影响，为该方案应用积累更多循证医学证据，现报道如下。, http://www.100md.com(蓝文涛 扶立华)
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