负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损

王迅

[摘要] 目的 分析足部軟组织缺损采用负压封闭引流、股前外侧穿支皮瓣进行修复联合治疗，探讨其疗效。方法 方便选取2017年2月—2018年2月在该院治疗的86例足部软组织缺损患者进行研究，随机分成2组，对照组43例，给予加压包扎与股前外侧穿支皮瓣修复联合治疗，观察组43例，给予负压封闭引流与股前外侧穿支皮瓣修复联合治疗，比较两组的换药次数、创面愈合、患肢恢复、愈合时间、感染等情况。结果 观察组患者感染率4.65%，对照组为16.28%（χ2=10.509，P=0.013），而观察组皮瓣成活率为95.35%，对照组为83.72%（χ2=9.883，P=0.034），观察组的创面愈合优良率为97.67%，对照组为88.37%（χ2=12.104，P=0.016），观察组患者手术时间更短，换药次数更少，创面愈合更快。感染率更低，皮瓣成活率更高，创面愈合效果更显著，两组比较差异有统计学意义（P<0.05）。 结论 足部软组织缺损实施负压封闭引流与股前外侧穿支皮瓣修复进行联合治疗，换药次数少、创年愈合快，有效恢复患肢功能，降低感染，快速修复缺损，皮瓣移植成功率高，取得显著的临床效果，具有重要的临床研究价值。

[关键词] 足部软组织缺损；负压封闭引流技术；穿支皮瓣修复术

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2019）03（b）-0054-03

[Abstract] Objective To analyze the soft tissue defect of the foot with negative pressure closed drainage and anterior femoral perforator flap for repair and treatment. Methods 86 patients with soft tissue defects of the foot treated in our hospital from February 2017 to February 2018 were convenient enrolled in the study. They were randomly divided into two groups and 43 patients in the control group， the combination of compression dressing and anterior femoral perforator flap repair was performed. In the treatment group， 43 cases were treated with negative pressure closed drainage combined with anterior and posterior femoral perforator flap repair. The number of dressing changes， wound healing， limb recovery， healing time and infection were compared between the two groups. Results The infection rate of the observation group was 4.65%， and that of the control group was 16.28% （χ2=10.509， P=0.013）. The survival rate of the flap was 95.35% in the observation group and 83.72% in the control group （χ2=9.883， P=0.034）. The excellent rate of wound healing in the observation group was 97.67%， and that in the control group was 88.37% （χ2=12.104， P=0.016）. The observation group had shorter operation time， fewer dressings， and faster wound healing. The infection rate was lower， the flap survival rate was higher， and the wound healing effect was more significant. There was a significant difference between the two groups， which was statistically significant（P<0.05）. Conclusion The soft tissue defect of the foot is treated with negative pressure closed drainage and anterior lateral femoral perforator flap repair. The number of dressing changes is small， the healing of the wound is fast， the function of the affected limb is effectively restored， the infection is reduced， the defect is repaired quickly， and the flap is successfully transplanted. The rate is high， achieving significant clinical results and having important clinical research value.