中国现代手术学杂志2025，Vol.29Issue(2)：141-146,6.DOI:10.16260/j.cnki.1009-2188.2025.02.009
远端蒂腓肠皮瓣在老年患者下肢远端皮肤软组织缺损中的临床应用
Clinical application of distally based sural flap in elderly patients with soft tissue defects in distal lower extremity
摘要
Abstract
Objective To investigate and evaluate the clinical efficacy of the distally based sural flap in repairing skin and soft tissue defects in the distal lower extremity of elderly patients.Methods From March 2005 to December 2023,a total of 53 elderly patients(aged ≥ 60 years)with skin and soft tissue de-fects in the distal lower extremity were treated using the distally based sural flap.The cohort included 35 males and 18 females,aged 60～81 years(with an average age of 66.7 years).The causes of the defects were trauma(29 cases),chronic osteomyelitis(12 cases),chronic ulcers(6 cases),and soft tissue tumors(6 cases).The defects were located at the anterior tibia(12 cases),ankle(10 cases),posterior heel and plantar re-gion(21 cases),and foot(10 cases).The wound sizes after debridement ranged from 4.0 cm×5.0 cm to 18.0 cm×8.0 cm,and the flap sizes ranged from 5.0 cm×6.0 cm to 19.5 cm×9.5 cm.Results Among the 53 distally based sural flaps,48 achieved complete survival,while 5 experienced partial necrosis.Among these 5 cases,2 required amputation due to squamous cell carcinoma and uncontrollable infection,respectively.All patients were followed up for 3～121 months(with an average of 13.59 months).Except for the two amputated cases,all patients were satisfied with the functional and aesthetic outcomes of the flaps.According to the American Orthopedic Foot and Ankle Society(AOFAS)hindfoot-ankle function score,38 cases were rated as excellent and 13 cases as good.Conclusions The distally based sural flap is an effective and reliable method for repairing skin and soft tissue defects in the distal lower extremity of elderly patients.This technique allows for single-stage flap harvest and transfer,demonstrating relative safety without the need of delay procedures.关键词
腓肠皮瓣/外科皮瓣/软组织缺损/下肢/老年人Key words
sural flaps/surgical flaps/soft tissue defects/lower extremity/the elderly引用本文复制引用
张理军,董忠根,魏建伟,彭平,任珍锐,蒋颖良..远端蒂腓肠皮瓣在老年患者下肢远端皮肤软组织缺损中的临床应用[J].中国现代手术学杂志,2025,29(2):141-146,6.基金项目
湖南省自然科学基金面上项目(2022JJ30852) （2022JJ30852）
