腓动脉穿支蒂腓肠神经营养血管皮瓣的临床应用  

CLINICAL APPLICATION OF SURAL NERVE NUTRITIONAL VESSEL AXIAL FLAP PEDICLED WITH THE PERFORATING BRANCH OF THE PERONEAL ARTERY

作　　者：王快胜[1] 柴益民[1] 邱勋永[1] 马心赤[1] 林崇正[1] 陈彦[1] 

机构地区：[1]海南省人民医院显微手外科,海口570311

出　　处：《中国修复重建外科杂志》2005年第12期998-1000,共3页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：海南省自然科学基金资助项目(30217)~~

摘　　要：目的探讨应用改进腓肠神经营养血管皮瓣修复小腿下段及足踝部皮肤软组织缺损的手术方法及临床效果。方法1999年1月~2004年11月,在腓动脉肌间隔支与腓肠神经血供的解剖基础上临床应用22例。其中男14例,女8例。年龄5~54岁。根据缺损部位及大小设计以腓动脉小腿下段穿支为血管蒂及转轴点,沿腓肠神经营养血管轴线切取皮瓣,逆行移位修复小腿下段及足踝部皮肤软组织缺损。应用腓动脉终末穿支蒂皮瓣13例,腓动脉第2穿支蒂皮瓣8例,第3穿支蒂皮瓣1例。切取皮瓣范围13 cm×12 cm^30 cm×20 cm,穿支血管蒂长1.7~3.0 cm,穿支血管蒂发出部位位于外踝上4.5~8.0 cm,血管外径1.0~1.2 mm。结果术后22例皮瓣全部成活,随访6~18个月,皮瓣外形及功能恢复满意。其中4例腓肠神经与受区感觉神经吻合,术后1年感觉恢复好,两点辨别觉为10~13 mm。结论腓动脉穿支蒂腓肠神经营养血管皮瓣手术操作简便,血供可靠,切取面积大,适用于修复小腿下段及足踝部大面积皮肤软组织缺损。Objective To explore the application of the improved operative technique and clinical results of sural nerve nutritional vessel axial flap repairing the soft tissue defects of the lower leg,the ankle and the foot. Methods From January 1999 to Novenber 2004,the modified flaps were applied in 22 cases of soft tissue defect on the basis of anatomy of the intermusclar septum perforating branches of peroneal artery and the sural nerve nutritional vessel. There were 14 males and 8 females. Their ages ranged from 5 to 54 years. According to the position and size of the soft tissue defects, the sural nerve nutritional vessel flap pedicled with the perforating branch of the peroneal artery in the lower leg were desingned and obtained to repair the soft tissue defects of the lower leg,the ankle and the foot. The flap size ranged from 13cm × 12cm to 30cm ×20cm. The vessel pedicle of perforating branches ranged from 1. 7cm to 3cm. The distribution of the vessel pedicle of perforating branches ranged from 4. 5cm to 8cm on the lateral malleolus. The diameters of vessel ranged from 1ram to 1.2mm. Results The flap pedicle with the terminal branch of the peroneal artery was used in 13 cases, the other branches were used in 9 cases. Among of 22 cases, the sural nerve were anastomosed with the acceptor sensory nerve in 4 cases. The skin sense were satisfactory after 1 year of operation and 2-point discrimination was 10-13mm. All flaps survived completely in 22 cases. The outline and function were satisfactory during 6 18 months follow up. Conclusion The blood supply of this flap is reliable. Flap elevation is easy. The size of flap is large enough to repair skin defects of the lower leg, the ankle and the foot.

关 键 词：腓动脉 腓肠神经 血管穿支 皮瓣 修复 

分 类 号：R658.3[医药卫生—外科学]