不同方法修复儿童足跟轮辐伤皮肤缺损伴跟腱外露

目的 探讨不同方法 修复儿童足跟轮辐伤皮肤缺损伴跟腱外露的临床效果.方法 采用腓肠神经营养血管皮瓣、足跟外侧动脉皮瓣和邻位局部内侧或外侧旋转皮瓣3种皮瓣以及人工真皮覆盖修复22例儿童足跟部轮辐伤皮肤缺损伴跟腱外露创面.观察创面愈合情况.结果 患儿均获得随访,时间3～10个月.2例腓肠神经营养血管皮瓣远端皮缘发生血运障碍...

Different methods for repairing heel skin defect with achilles tendon exposure suffered from spoke injuries in children

Objective To investigate the clinical efficacy of different methods for repairing heel skin defect with exposure of ahilles tendon suffered from spoke injuries in children.Methods The 22 children with heel skin defect with exposure of ahilles tendon who were suffered from spoke injuries were selected,they were treated with three kinds of flaps(sural neurovascular flap,heel lateral artery flap,local medial and lateral rotation flap)and artificial dermis covering.The wound healing situation was observed.Results All patients were followed up for 3~10 months.The 2 cases who had blood circulation disorder at the distal margin of sural neurovascular flap caused a small part of the skin margin ischemic necrosis,1 case had ischemic necrosis at the distal part of lateral heel artery flap,and the 2 children who were repaired by artificial dermis had mild infection of the wound surface.The wounds of the above children healed gradually after dressing change;the other children′s wounds healed smoothly.At the last follow-up,the affected feet was without bloated appearance,they had normal flexion-extension activities of ankle joint,there was no effect on their walking with shoes.Conclusions According to the size and shape of skin defect in the heel,good clinical effects can be achieved by using different methods to repair heel skin defect with exposure of ahilles tendon suffered from spoke injuries in children.However,the principle that the skin flap can not be far away,carry the pedicle does not anastomose vascular repair should be followed,and the principle of minimally invasive and aesthetic concepts should be established in strict accordance with the requirements of the incision of the flap.