目的：探讨皮瓣与持续封闭负压引流技术（VSD）组合性选择在小腿节段性毁损伤软组织缺损修复中的应用价值。方法2010年1月-2014年12月共收治小腿节段性毁损伤软组织缺损患者25例，对创面进行皮瓣修复和（或）结合VSD、游离植皮技术修复。结果25例患者全部随访，随访时间3个月~56个月。25例患者中优8例（32.00%），良好13例（52.00%），尚可3例（12.00%），差1例（4.00%）。结论皮瓣与VSD应综合性使用，以最佳功能形态恢复为目的，最少副损伤为参照。软组织缺损创面仅需覆盖者，单纯植皮；严重深部毁损、合并感染需肌皮瓣修复者，部分可使用VSD优化创面，简化为植皮或者筋膜皮瓣修复。应避免VSD引流肉芽修复过盛所致肌腱瘢痕粘连，部分可选择舍弃负压引流而直接皮瓣修复。%ObjectiveTo explore the flap combined with VSD sexual selection in the calf segmental destroyed the value of soft tissue defect.MethodsFrom January 2010 to December 2014,Total calf segmental destructive injury treated 25 cases of patients with soft tissue defect,the wound skin flap to repair and/or in combination with the VSD continuous seal negative pressure drainage technology,free skin graft to repair.ResultsAll the 25 patients were followed up for 3~56 months,25 cases of calf segmental destructive injury with soft tissue defect,there were 8 cases excellent (32%),13 cases good(52%),3 cases acceptable(12%),and 1 case poor(4%).ConclusionThe skin flap with VSD should comprehensive use,in order to best shape function,for the purpose of the least damage as reference. Soft tissue defect wound only cover,pure skin graft;Serious deep infection to myocutaneous flap to repair damaged,to the merger, the part can use the VSD optimization wound,simplified as skin grafts or fascia flap repair. The VSD drainage granulation repair of tendon scar adhesion can be avoided,and partial choice of drainage can be avoided and the direct skin flap is repaired.
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