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观察负压封闭引流（VSD）联合穿支皮瓣移植在足踝软组织缺损治疗中的应用效果。
选取于2018年5月—2020年5月到单县中心医院就诊的足踝软组织缺损病例60例，分为观察组（VSD + 穿支皮瓣移植）与对照组（传统创面 + 穿支皮瓣移植），各30例。比较两组患者治疗相关指标、治疗前后踝关节功能评分（Kphoed）、疼痛评分（VAS）、治疗效果，随访并发症发生率。
观察组手术、抗生素应用及住院用时相较于对照组短，且观察组换药次数、皮瓣切取面积少于对照组，差异有统计学意义（P < 0.05）；两组患者Kphoed评分经过治疗有所提高，VAS评分降低，优于治疗前，观察组治疗后各项评分较对照组好（P < 0.05），差异有统计学意义；观察组总有效率的93.3%较对照组的70.0%高，差异有统计学意义（P < 0.05）；两组并发症发生率比较观察组较对照组低（6.7% vs 26.7%），差异有统计学意义（P < 0.05）。
VSD联合穿支皮瓣移植，在改善患者心理状况及生活质量方面作用显著，有利于减少不良事件的发生，可在临床广泛推广。
| 1 | 谭慎兴，卢小生，曹哲，等.小腿外侧肌皮穿支皮瓣修复足踝部软组织缺损的临床疗效［J］.中华医学美学美容杂志，2020，26（4）：335. |
| 2 | 翟旭，邵新中.胫前动脉踝上穿支皮瓣修复足踝部软组织缺损19例［J］.中华显微外科杂志，2020，43（1）：24. |
| 3 | 吴朝君.肌骨超声在创伤性浅表软组织损伤诊断中的应用［J］. 实用手外科杂志， 2020， 21（1）：97. |
| 4 | 丁春雷，邓建龙.腓肠神经营养血管筋膜皮瓣修复小腿及足踝部软组织缺损创面的临床效果［J］.中国骨与关节损伤杂志，2019，34（2）：210. |
| 5 | 农明善，陈凯宁，罗柳宁，等.不同类型皮瓣在足踝部软组织缺损的修复应用［J］.创伤外科杂志，2019，21（4）：244. |
| 6 | 张景僚，蔡俊雅，李丹丹，等.胫后动脉穿支皮瓣在修复足踝部软组织缺损中的应用［J］.实用手外科杂志，2016，30（3）：354. |
| 7 | 尹路，宫可同，殷中罡，等.游离穿支皮瓣联合游离植皮修复足踝部软组织缺损的疗效观察［J］.中国修复重建外科杂志，2017，31（3）：319. |
| 8 | 李战营. 负压封闭引流联合逆行隐神经营养皮瓣移植修复足踝部皮肤软组织缺损创面效果观察［J］. 河南外科学杂志，2020，26（2）：139. |
| 9 | 周征兵，唐举玉，吴攀峰，等. 双侧旋股外侧动脉降支穿支皮瓣组合移植修复下肢大面积软组织缺损［J］. 中华显微外科杂志，2020，43（6）：535. |
| 10 | 霍君艺，赵卓伟，全猛，等. VSD联合胫后动脉内踝上穿支皮瓣修复足踝部皮肤软组织缺损［J］. 中国美容整形外科杂志，2020，31（11）：672. |
| 11 | 蓝波，傅尚俊，杨锦，等. 游离股前外侧穿支薄皮瓣联合负压封闭引流术修复足踝部创面［J］. 实用手外科杂志，2019，33（3）：298. |
| 12 | 李吉利，姚恒，王炜，等. 负压封闭引流联合逆行隐神经营养皮瓣移植对足踝部皮肤软组织缺损创面愈合的影响［J］. 中国煤炭工业医学杂志，2017，20（12）：1407. |
| 13 | 黄凯，郭峭峰，林炳远，等. 负压封闭引流联合游离股前外侧皮瓣治疗小儿足踝部软组织缺损［J］. 中华整形外科杂志，2016，32（3）：225. |
| 14 | 周盟森，颜屈伦，张普，等. 足踝部皮肤软组织缺损应用VSD联合腓动脉穿支皮瓣修复的临床疗效［J］. 实用手外科杂志，2017，31（1）：68. |
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Sixty cases of soft tissue defect of the ankle were from our hospital from May 2018 to May 2020. There were 30 cases in the observation group （VSD + perforator flap transplantation） and the control group （traditional wound + perforator flap transplantation）respectively.Treatment related indicators，ankle function score （Kphoed），pain score （VAS），treatment effect，and incidence of complications were compared between the two groups before and after treatment.
Compared with the control group，the duration of surgery，antibiotic application and hospitalization in the observation group was shorter，and the number of dressing changes and the area of skin flap incision in the observation group were less than those in the control group，with statistically significant differences （P < 0.05）；After treatment，Kphoed scores of patients in both groups were improved，while VAS scores were decreased，which were better than those before treatment， and statistically significant （P < 0.05）；The total effective rate of 93.3% in the observation group was higher than that of 70.0% in the control group，which was statistically significant （P < 0.05）； In the comparison of complication rates between the two groups， the observation group was lower than the control group （6.7% vs 26.7%） （P < 0.05）.
VSD combined with perforator flap transplantation plays a significant role in improving patients' psychological status and quality of life，which is conducive to reduce the occurrence of adverse events，and can be widely promoted in clinical practice.
), Fang Zhang","risUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=Ris&id=157","title_en":"Application of closed drainage with negative pressure combined with perforator flap transplantation in the treatment of soft tissue defect of foot and ankle","hasPdf":"true"},"authorNotes_cn":["姜新强，副主任医师，硕士，主要从事临床骨科工作，E-mail：jzy96027@163.com。"],"authorList_en":[{"zuoZheDiZhiL_cn":["单县中心医院骨一科，山东 菏泽 274300 ;"],"deceased":false,"name_cn":"姜新强","email":"jzy96027@163.com","zuoZheDiZhiL_en":["Dept. of Osteology，Shanxian Central Hospital，Heze 274300，China ;"],"name_en":"Xinqiang Jiang"},{"zuoZheDiZhiL_cn":["单县中心医院骨一科，山东 菏泽 274300 ;"],"deceased":false,"name_cn":"张防","zuoZheDiZhiL_en":["Dept. of Osteology，Shanxian Central Hospital，Heze 274300，China ;"],"name_en":"Fang Zhang"}]}">
Application of closed drainage with negative pressure combined with perforator flap transplantation in the treatment of soft tissue defect of foot and ankle
Xinqiang Jiang, Fang Zhang
Journal of ShanDong First Medical University&ShanDong Academy of Medical Sciences››2021, Vol. 42››Issue (8): 617-620.
PDF(428 KB)
PDF(428 KB)
Application of closed drainage with negative pressure combined with perforator flap transplantation in the treatment of soft tissue defect of foot and ankle
To observe the effect of negative pressure closed drainage （VSD） combined with perforator flap transplantation in the treatment of ankle soft tissue defect.
Sixty cases of soft tissue defect of the ankle were from our hospital from May 2018 to May 2020. There were 30 cases in the observation group （VSD + perforator flap transplantation） and the control group （traditional wound + perforator flap transplantation）respectively.Treatment related indicators，ankle function score （Kphoed），pain score （VAS），treatment effect，and incidence of complications were compared between the two groups before and after treatment.
Compared with the control group，the duration of surgery，antibiotic application and hospitalization in the observation group was shorter，and the number of dressing changes and the area of skin flap incision in the observation group were less than those in the control group，with statistically significant differences （P< 0.05）；After treatment，Kphoed scores of patients in both groups were improved，while VAS scores were decreased，which were better than those before treatment， and statistically significant （P< 0.05）；The total effective rate of 93.3% in the observation group was higher than that of 70.0% in the control group，which was statistically significant （P< 0.05）； In the comparison of complication rates between the two groups， the observation group was lower than the control group （6.7% vs 26.7%） （P< 0.05）.
VSD combined with perforator flap transplantation plays a significant role in improving patients' psychological status and quality of life，which is conducive to reduce the occurrence of adverse events，and can be widely promoted in clinical practice.
negative pressure closed drainage/transplanting perforator flap/soft tissue defect of ankle/ankle function score/complications
| 1 | 谭慎兴，卢小生，曹哲，等.小腿外侧肌皮穿支皮瓣修复足踝部软组织缺损的临床疗效［J］.中华医学美学美容杂志，2020，26（4）：335. |
| 2 | 翟旭，邵新中.胫前动脉踝上穿支皮瓣修复足踝部软组织缺损19例［J］.中华显微外科杂志，2020，43（1）：24. |
| 3 | 吴朝君.肌骨超声在创伤性浅表软组织损伤诊断中的应用［J］. 实用手外科杂志， 2020， 21（1）：97. |
| 4 | 丁春雷，邓建龙.腓肠神经营养血管筋膜皮瓣修复小腿及足踝部软组织缺损创面的临床效果［J］.中国骨与关节损伤杂志，2019，34（2）：210. |
| 5 | 农明善，陈凯宁，罗柳宁，等.不同类型皮瓣在足踝部软组织缺损的修复应用［J］.创伤外科杂志，2019，21（4）：244. |
| 6 | 张景僚，蔡俊雅，李丹丹，等.胫后动脉穿支皮瓣在修复足踝部软组织缺损中的应用［J］.实用手外科杂志，2016，30（3）：354. |
| 7 | 尹路，宫可同，殷中罡，等.游离穿支皮瓣联合游离植皮修复足踝部软组织缺损的疗效观察［J］.中国修复重建外科杂志，2017，31（3）：319. |
| 8 | 李战营. 负压封闭引流联合逆行隐神经营养皮瓣移植修复足踝部皮肤软组织缺损创面效果观察［J］. 河南外科学杂志，2020，26（2）：139. |
| 9 | 周征兵，唐举玉，吴攀峰，等. 双侧旋股外侧动脉降支穿支皮瓣组合移植修复下肢大面积软组织缺损［J］. 中华显微外科杂志，2020，43（6）：535. |
| 10 | 霍君艺，赵卓伟，全猛，等. VSD联合胫后动脉内踝上穿支皮瓣修复足踝部皮肤软组织缺损［J］. 中国美容整形外科杂志，2020，31（11）：672. |
| 11 | 蓝波，傅尚俊，杨锦，等. 游离股前外侧穿支薄皮瓣联合负压封闭引流术修复足踝部创面［J］. 实用手外科杂志，2019，33（3）：298. |
| 12 | 李吉利，姚恒，王炜，等. 负压封闭引流联合逆行隐神经营养皮瓣移植对足踝部皮肤软组织缺损创面愈合的影响［J］. 中国煤炭工业医学杂志，2017，20（12）：1407. |
| 13 | 黄凯，郭峭峰，林炳远，等. 负压封闭引流联合游离股前外侧皮瓣治疗小儿足踝部软组织缺损［J］. 中华整形外科杂志，2016，32（3）：225. |
| 14 | 周盟森，颜屈伦，张普，等. 足踝部皮肤软组织缺损应用VSD联合腓动脉穿支皮瓣修复的临床疗效［J］. 实用手外科杂志，2017，31（1）：68. |
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