检验医学与临床2025，Vol.22Issue(10)：1368-1373,6.DOI:10.3969/j.issn.1672-9455.2025.10.014
不同皮瓣修复足踝部软组织缺损的效果及对患者关节功能、炎症因子水平的影响
Effects of different flaps on repairing foot and ankle soft tissue defects and their effects on joint function and inflammatory factor levels of patients
摘要
Abstract
Objective To explore the effects of different flaps on repairing foot and ankle soft tissue defects and their effects on joint function and inflammatory factor levels.Methods A total of 96 patients with foot and ankle soft tissue defects admitted to Baoji People's Hospital of Shaanxi Province from February 2022 to November 2023 were selected as the research objects.According to different repair methods,the patients were divided into group A(undergoing reverse island fasciocutaneous flap repair of sural nerve nutrient vessels)and group B(undergoing anterolateral thigh perforator flap),with 48 cases in each group.The operation time,flap survival rate,wound healing,flap sensory function,ankle joint function[ankle-hindfoot scoring system(AOFAS)score],inflammatory factors[soluble intercellular adhesion molecule-1(sICAM-1),interleukin-6(IL-6),soluble vascular cell adhesion molecule-1(sVCAM-1),tumor necrosis factor-α(TNF-α)]levels and complications were compared between the two groups.Results The operation time of group A was shorter than that of group B,and the proportion of first-level wound healing grade was better than that of group B,and the differences were significant(P＜0.05).There was no significant difference in flap survival rate be-tween 2 groups(P＞0.05).At 6 months after operation,there were 3 cases of S1 grade,15 cases of S2 grade,and 30 cases of S3 grade in group A,and 8 cases of S1 grade,25 cases of S2 grade,and 15 cases of S3 grade in group B,there were significant differences in sensory function grades of flaps between the two groups(P＜0.05).After 6 months of treatment,the AOFAS pain scores of the two groups were lower than those before treatment,and the function and social role scores were higher than those before treatment,and the AOFAS pain score of the group A was lower than that of the group B,and the function and social role scores were higher than those of the group B,and the differences were statistically significant(P＜0.05).There was no significant difference in the levels of slCAM-1,IL-6,SVCAM-1,and TNF-α between the two groups before treatment(P＞0.05).After 1 month of treatment,the levels of slCAM-1,IL-6,SVCAM-1 and TNF-α in the two groups were lower than those before treatment,and those in group A were lower than those in group B,and the differences were statistically significant(P＜0.05).There was no significant difference in the total in-cidence of complications after successful transplantation between the two groups(x2=0.447,P=0.504).Conclusion Compared with the anterolateral thigh perforator flap,the reverse sural nerve nutrient vessel is-land fasciocutaneous flap is more valuable in the treatment of foot and ankle soft tissue injuries.It can also shorten the operation time,improve the wound inflammatory response,and reduce the risk of complications.关键词
皮瓣修复/足踝部软组织缺损/腓肠神经营养血管逆行岛状筋膜蒂皮瓣/股前外侧穿支皮瓣Key words
flap repair/soft tissue defect of foot and ankle/reverse sural neurovascular island fasciocu-taneous flap/anterolateral thigh perforator flap分类
医药卫生引用本文复制引用
李小龙,甘永杰,段冰,衡立松..不同皮瓣修复足踝部软组织缺损的效果及对患者关节功能、炎症因子水平的影响[J].检验医学与临床,2025,22(10):1368-1373,6.基金项目
陕西省重点研发计划项目(2022SF-525). （2022SF-525）
