郑力文　　李波

[摘要] 目的 探討经封闭式负压引流后应用游离股前外侧皮瓣移植修复足部皮肤缺损的临床疗效。 方法 选取2017年1月至2019年1月我院收治的76例足部皮肤缺损患者，随机分为两组，对照组进行经封闭式负压引流治疗，研究组在对照组基础上进行游离股前外侧皮瓣移植修复。比较两组治疗总有效率、生活质量评分、感觉功能恢复状况、植皮成功率。 结果 与对照组比较，研究组治疗总有效率更高（P<0.05）;与对照组比较，研究组生活质量评分更高（P<0.05）;与对照组比较，研究组S3、S1区感觉功能恢复率更高（P<0.05），但其余区感觉功能恢复没有明显差异;与对照组比较，研究组植皮成功率更高（P<0.05）。 结论 对足部皮肤缺损患者，应用经封闭式负压引流治疗基础上联合游离股前外侧皮瓣移植修复治疗，效果理想，可提高皮瓣移植成功率，改善生活质量，恢复部分感觉功能。因此，该治疗方法值得广泛应用。

[关键词] 经封闭式负压引流;股前外侧皮瓣移植修复;皮瓣移植修复;足部皮肤缺损

[中图分类号] R658.3          [文献标识码] B          [文章编号] 1673-9701（2021）11-0100-04

Clinical effect of free anterolateral thigh flap transplantation in repairing foot skin defect after closed negative pressure drainage

ZHENG Liwen   LI Bo

Department of Burns and Plastic Surgery， Hengyang NO.1 People′s Hospital in Hu′nan Province， Hengyang   421002， China

[Abstract] Objective To investigate the clinical effect of free anterolateral thigh flap transplantation in repairing foot skin defects after closed negative pressure drainage. Methods A total of 76 patients with foot skin defects admitted to our hospital from January 2017 to January 2019 were randomly divided into two groups. The control group received closed negative pressure drainage treatment， and the study group received free transplantation of anterolateral flaps based on the treatment of the control group. The treatment efficiency， quality of life score， sensory function recovery status， and success rate of skin grafts were compared between the two groups. Results The treatment total efficiency of the study group was higher than that of the control group（P<0.05）. The quality of life score in the study group was higher than that of the control group（P<0.05）. The S3， S1 area sensory function recovery rate of the study group was higher than that of the control group（P<0.05）. But there was no significant difference in sensory function recovery in other areas. The success rate of skin grafting in the study group was higher than that of the control group（P<0.05）. Conclusion For patients with foot skin defects， the application of closed negative pressure drainage therapy combined with free anterolateral femoral flap transplantation has satisfactory results. It can increase the success rate of flap transplantation， improve the quality of life， and restore some sensory functions. Therefore， this treatment method should be widely used.

[Key words] Closed negative pressure drainage; Anterolateral thigh flap transplantation; Skin flap transplantation repair; Foot skin defect

交通事故、热烧伤、砸伤、机械碾压易导致软组织缺损，足部皮肤缺损其特点为背薄底厚，临床治疗具有较大治疗难度，且操作繁琐[1]。足部皮肤缺损影响患者正常生活，患者心理压力较大。因此，临床应研究合适的治疗方法，带蒂皮瓣转移修复为临床常见修复方法，效果较好，但对足部皮肤缺损患者，该治疗方法会破坏邻近主要血管，并不能完善神经感觉支配，修复效果欠佳，容易引发术后并发症，安全性相对较低[2]。应用股前外侧皮瓣移植修复可保证皮瓣血管与缺损部位有效吻合，血液供应恢复正常，实现足部缺损皮肤修复[3]。该研究围绕经封闭式负压引流后应用游离股前外侧皮瓣移植修复足部皮肤缺损的临床疗效研究，希望修复足部缺损皮肤，提高感觉功能，恢复正常生活，现报道如下。

1 资料与方法

1.1一般资料

选取2017年1月至2019年1月我院收治的76例足部皮肤缺损患者。……