負壓封閉引流聯合股前外側穿支皮瓣修復足部軟組織缺損

王迅

[摘要] 目的 分析足部軟組織缺損采用負壓封閉引流、股前外側穿支皮瓣進行修復聯合治療，探討其療效。方法 方便選取2017年2月—2018年2月在該院治療的86例足部軟組織缺損患者進行研究，隨機分成2組，對照組43例，給予加壓包扎與股前外側穿支皮瓣修復聯合治療，觀察組43例，給予負壓封閉引流與股前外側穿支皮瓣修復聯合治療，比較兩組的換藥次數、創面愈合、患肢恢復、愈合時間、感染等情況。結果 觀察組患者感染率4.65%，對照組為16.28%（χ2=10.509，P=0.013），而觀察組皮瓣成活率為95.35%，對照組為83.72%（χ2=9.883，P=0.034），觀察組的創面愈合優良率為97.67%，對照組為88.37%（χ2=12.104，P=0.016），觀察組患者手術時間更短，換藥次數更少，創面愈合更快。感染率更低，皮瓣成活率更高，創面愈合效果更顯著，兩組比較差異有統計學意義（P<0.05）。 結論 足部軟組織缺損實施負壓封閉引流與股前外側穿支皮瓣修復進行聯合治療，換藥次數少、創年愈合快，有效恢復患肢功能，降低感染，快速修復缺損，皮瓣移植成功率高，取得顯著的臨床效果，具有重要的臨床研究價值。

[關鍵詞] 足部軟組織缺損；負壓封閉引流技術；穿支皮瓣修復術

[中圖分類號] R4 [文獻標識碼] A [文章編號] 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.