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目的报道应用足背分叶皮瓣一次修复多个手指电烧伤组织缺损的治疗效果。方法创面进行清创后,分别设计以胫前、足背血管为主干,跗内侧、第1跖背、跗外侧血管为分支,构成的足内侧、第1跖背、足外侧三叶皮瓣或以第1跖背、跗外侧血管为分支构成的第1跖背、足外侧双叶皮瓣移植一次修复2～3指皮肤软组织缺损,合并屈肌腱、血管、神经缺损的病例,以携带的趾长伸肌腱重建肌腱缺损,以足背动脉的分支血管桥接指动脉,以携带皮神经重建皮瓣感觉的同时重建手指远端的感觉。结果移植皮瓣全部成活,手指创口一期愈合,供足植皮部分坏死2例,1例经局部换药3周后愈合,1例肌腱外露行内踝上皮瓣移位修复后愈合。术后经3～24个月随访,皮瓣外形,质地良好,感觉恢复S_(3+)级,5例手指屈伸活动恢复正常,2例手指屈伸轻微受限。结论足背分叶皮瓣游离移植是修复多指电烧伤组织缺损最为理想的治疗方法。
Objective To report the treatment effect of repairing multiple finger electric burn tissue defects using the dorsal foot flap. Methods After the debridement of wounds, the medial plantar, the first metatarsal and the lateral pedicel flap were designed respectively with the anterior tibial and dorsal blood vessels as the trunk, medial pterygoid medialis, the first plantar dorsal and the lateral pterygoid blood vessels as the branches, To the first plantar dorsal, 跗 lateral blood vessels as the branch of the first plantar dorsal metatarsal lateral pedicel skin flap graft 2 to 3 refers to the repair of the skin and soft tissue defects, flexor tendon, vascular, nerve defects in cases, to carry the toes Long extensor tendon reconstruction tendon defects, the dorsalis pedis artery branching blood vessels to bridge the artery to carry skin nerve reconstruction flap feeling while reconstructing the distal end of the finger feeling. Results The allograft flaps survived. The wounds of the fingers were healed one time, two cases were necrosis of the skin graft, one case healed after 3 weeks local dressing and one case of tendon healed by displacement of the medial malleolus flap. After 3 to 24 months of follow-up, the skin shape and texture were good, S_ (3+) level was recovered, and 5 cases of finger flexion and extension activities returned to normal. Conclusion The free dorsal plantar autograft is the most ideal method to repair multi-finger electric burn tissue defect.