摘要
目的 探析旋股外侧穿支动脉体区组织瓣对糖尿病足患者肢体远期疗效。方法 对2022年5月-2024年11月在玉林市第一人民医院烧伤整形外科行旋股外侧穿支动脉体区组织瓣重建的糖尿病足溃疡患者共32例，男24例,女8例,年龄33-75岁，平均58岁，所有患者均为Wagner分级Ⅲ级或Ⅳ级的糖尿病足,糖尿病病史5-22年。应用旋股外侧穿支动脉体区组织瓣，术后所有患者均规律化门诊随访。结果 随访12-21个月，平均15.6个月。随访期间，供区均愈合良好，仅残留线性瘢痕；32例患者皮瓣完全成活，无皮瓣坏死。末次随访时，4例患者出现新发溃疡，均是因为未正规穿戴减张鞋，但经过换药后愈合；皮瓣质地良好、外形佳，患者日常行走无明显障碍。结论 重症糖尿病足运用旋股外侧穿支动脉体区组织瓣对患者肢体远期效果较好。
关键词： 糖尿病足；慢性创面；旋股外侧穿支动脉体区组织瓣
Abstract
Objective To explore the long-term efficacy of the lateral circumflex femoral artery perforator (LCFAP) body flap in the treatment of diabetic foot ulcers. Methods A total of 32 patients with diabetic foot ulcers (24 males and 8 females, aged 33 to 75 years, with an average age of 58 years) who underwent LCFAP body flap reconstruction in the Department of Burn and Plastic Surgery of Yulin First People's Hospital from May 2022 to November 2024 were included. All patients had Wagner grade III or IV diabetic foot ulcers and a history of diabetes ranging from 5 to 22 years. The LCFAP body flap was applied, and all patients were followed up regularly in the outpatient department after surgery. Results The follow-up period ranged from 12 to 21 months, with an average of 15.6 months. During the follow-up, the donor sites healed well, leaving only linear scars. All 32 flaps survived completely without necrosis. At the last follow-up, 4 patients developed new ulcers due to non-compliance with wearing decompression shoes, but they healed after dressing changes. The flaps had good texture and appearance, and the patients had no significant walking difficulties in daily life. Conclusion The LCFAP body flap is effective for the long-term treatment of severe diabetic foot ulcers.
Key words： Diabetic foot; Chronic wound; Lateral circumflex femoral artery perforator body flap
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