PDF(Pubmed)
Abstract：
The purpose of this study was to compare the reconstructive outcomes of soft-tissue defects around foot and ankle with vaccum sealing drainage (VSD) or induction membrane (IM) of cement formation and attempt to provide an optimal strategy for elderly patients. A retrospective review of all continuous patients with foot and ankle reconstruction using different flaps from October of 2016 and October of 2020 was performed. Based on the different way, the patients were divided into two groups: VSD group (n = 26) and IM group (n = 27). Outcomes were assessed according to the size of the defect, frequency of debridement procedures, hospitalization time, duration of healing, the healing rate, major amputation rate, functional outcomes and complications. Immunohistochemistry (IHC) detection of vascular endothelial growth factor (VEGF) was also be completed. We found that there was no difference in demographic characteristics, size of the defect, debridement times and functional outcomes between the two groups (p > 0.05); however, a significant difference in the wound healing time, hospitalization time and complications were noted between them(p < 0.05). The fresh granulation tissue of both groups showed abundant positive expression of VEGF. Thus, the VSD and IM are both available for foot and ankle reconstruction in elderly patients. However, the IM group offers short hospitalization time, duration of healing and lower frequency of postoperative complications. Thus, we advocate the IM for reconstruction of defects of the foot and ankle region in the elderly patients.
摘要：
这项研究的目的是比较足部和踝关节周围软组织缺损的重建结果与真空封闭引流（VSD）或水泥形成的诱导膜（IM），并试图为老年患者提供最佳策略。回顾性回顾了2016年10月和2020年10月使用不同皮瓣进行足踝关节重建的所有连续患者。基于不同的方式，将患者分为两组：VSD组（n=26）和IM组（n=27）。根据缺陷的大小评估结果，清创程序的频率，住院时间,愈合的持续时间，愈合率，主要截肢率，功能结果和并发症。还完成了血管内皮生长因子(VEGF)的免疫组织化学(IHC)检测。我们发现人口统计学特征没有差异，缺陷的大小，两组清创时间和功能结局(p>0.05)；然而，伤口愈合时间的显著差异，住院时间及并发症发生率差异有统计学意义(p<0.05)。两组新鲜肉芽组织均有大量VEGF阳性表达。因此，VSD和IM均可用于老年患者的足踝重建。然而,IM组住院时间短，愈合的持续时间和术后并发症的频率较低。因此，我们主张采用IM重建老年患者足踝部缺损。
