Microsurgical Repair Of Soft Tissue Defects Of The Forefoot

Objective: The main purpose is to summarize the clinical efficacy of thedifferent micro-surgery in soft tissue repair forefoot defect, Explore theadvantages and disadvantages of the various repair of soft tissue injuries,screening the best method of repair.Methods: Patients follow up period ranged from6months to2years. Theanalysis and comparison of five kinds of flaps and skin grafting front foot softtissue repair effects，Were cross leg skin flap2cases, Pedicled retrograde islandflap20cases, Vascularized free flap28cases, Continuous vacuum sealingdrainage plus skin grafting5cases.Results: Out of50, In addition to the3flaps part of the distal edgenecrosis,47flaps survived completely. Are more satisfied with the survival ofthe flap for forefoot fix the shape and function, postoperative17cases of freeflap bloated and scarring affect the appearance and quality of life line forplastic surgery.3cases of distal flap necrosis of flap，Sural nerve nutritionblood retrograde island flap3cases, Lateral malleolus on the fascia flap1case,The main reason for the pedicle cut larger and the rotation angle of the foot andankle wound repair larger flap. In addition, some of our pedicle flap line thenerve anastomosis flap shape and texture better after partial flap restore sensoryfunction, after the event, the flap without scarring and ulceration, foot functionnot been significantly affected by limit. Free flap skin without significantkeratosis, part of the margin of a small area of wear, blisters or ulcers, and doesnot affect the foot function.Conclusion: We conclude that: using transferred from flap to repair forefootsmall area of soft tissue defects as the preferred flap texture, simple operation,safe and reliable. But for the cases of soft tissue defects of the middle area of the forefoot Philippians intestinal neurotrophic vascular island flap and lateralfasciocutaneous flap pedicle flap is the first choice, especially in exposedtendon injury; such flap blood supplyrich, strong resistance to infection, and theappearance and function of the flap satisfaction, regardless of the patients withintraoperative nerve anastomosis after sensory function returned late functionalrecovery of great help. Free flap suitable for repairing large skin defect, but itfeels difficult to rebuild, the drawback is bloated appearance and local highincidence of pressure ulcers.The the local epidermal necrolysis line free skingraft to good effect. The principle is under the scope of the wound, the bloodsupply, depth and peripheral tissue, choose a simple, safe, reliable, good textureflap wound repair.