Regionalized coverage of the totally degloved foot by a combination of “Boat sock” style free flap and skin graft
Regionalized coverage of the totally degloved foot by a combination of “Boat sock” style free flap and skin graft
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通过“船袜”式游离皮瓣和植皮相结合，对完全脱开手套的足部进行区域性覆盖
DOI：
10.1016/j.injury.2022.02.015
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Ju-yu Tang
中科院分区：
文献类型：
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作者：
Qifeng Ou;Xiaolin Dou;Panfeng Wu;Zhengbing Zhou;Ding Pan;Ju-yu Tang
为了最大限度地恢复完全脱套足的形态和功能，同时又不过分引入显微外科技术的复杂性，我们提出了一种区域化的重建方法，其中高度功能的亚单位方法2011年6月至2017年12月，10名足部完全脱套伤患者接受了基于区域覆盖的重建。由于其外形类似于穿在高跟鞋上的船袜，我们将其命名为“船袜”襟翼。并发症如血管妥协，部分或全部皮瓣丢失，马蹄畸形和迟发性足底溃疡详细记录。还记录了二次手术。足部功能评价马里兰州足部评分在最后一次folio.Results21游离皮瓣用于“船袜”覆盖的高功能亚单位。皮瓣面积19× 5cm ~ 2 8 × 8 cm ~ 2，平均15 1cm ~ 2。其中1例皮瓣部分坏死，经保守治疗，1例皮瓣因无保护性感觉而烧伤。无马蹄足畸形、迟发性足底溃疡等并发症发生。二次手术包括2例肿瘤减积。平均马里兰州足部评分为90.4分。结论“船袜”皮瓣和皮肤移植的区域性覆盖可以作为一个标准的程序来重建完全脱套足，提供了多平面覆盖，轮廓良好的踝关节，耐磨损的足底，和折衷的手术复杂性的好处。
IntroductionTo maximize the morpho-functional recovery on the totally degloved foot while not excessively introducing the technical complexity of microsurgery, we present a regionalized reconstruction, in which the highly functional subunit (weight-bearing area and ankle-around area) is covered by free skin flaps, and the less functional subunit (dorsum) by skin graft.MethodsFrom June 2011 to December 2017, 10 patients who had total degloving injury on foot underwent reconstruction based on regionalized coverage. As the shape of combined flaps resemble a boat sock in high-heeled shoe, we name it as “Boat Sock” flaps. Complication like vascular compromise, partial or total flap loss, Equinus deformity and delayed plantar ulceration were documented elaborately. Secondary surgeries were also recorded. Foot function was evaluated by Maryland foot score at the last follow up.ResultsTwenty-one free skin flaps were used for “Boat sock” coverage on highly functional subunits. Flap dimension ranged from 19×5cm2to 28×8cm2(mean 151cm2). Among these flaps, one experienced partial necrosis which was treated conservatively, one experienced burn due to lack of protective sensation. Complication like Equinus deformity or delayed plantar ulceration did not occur. Secondary surgery included debulking on two cases. Mean Maryland foot score was 90.4.ConclusionThis regionalized coverage by “Boat Sock” flaps and skin graft could serve as a standard procedure for reconstruction of the totally degloved foot, by offering the benefits of multi-plane coverage, a well-contoured ankle, an abrasion-tolerant planta, and eclectic surgical complexities.