带薄层肌肉的腓肠神经营养血管岛状皮瓣的临床应用  

Clinical Application of Neuroadipofascial Pedicled Based Sural Nerve Island Myofascialcutaneous Flap

作　　者：许令余 宁金龙[2] 李小静[2] 张林[2] 朱飞[2] 高学宏[2] 丁浩[2] 左宗宝[2] 

机构地区：[1]舒城县人民医院外科,安徽省舒城县231300 [2]安徽医科大学第一附属医院整形外科,安徽省合肥市230022

出　　处：《组织工程与重建外科杂志》2007年第2期80-82,共3页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨对改进带薄层肌肉的腓肠神经营养血管岛状皮瓣的临床应用效果。方法自2004年7月以来,在原有腓肠神经营养血管岛状皮瓣设计基础上,将皮瓣设计切取携带薄层(0.5～1.5cm)厚度、小于皮瓣表面积的肌肉瓣临床应用9例:近端蒂2例,远端蒂7例;其中用于软组织缺损伴骨关节裸露、感染的充填修复4例,慢性骨髓炎死腔2例,小腿骨折内固定材料外露2例,胫骨下段骨折骨缺损不愈合1例。皮瓣最大18cm×12cm,最小12cm×7cm,蒂长4cm×7cm,蒂宽2.5cm×4cm。结果切取皮瓣带薄层肌肉面广泛渗血,肉质鲜红,皮瓣均完全成活,伤口一期愈合,经2月～2年随访,骨折缺损植骨早期愈合,功能外形恢复满意。结论带薄层肌肉的腓肠神经营养血管岛状皮瓣,血运更为丰富,抗感染率增强,有利于骨感染伤口和骨折愈合。此类型皮瓣是对上述特殊病例的简便、有效且损伤小的修复方法。Objective Dissect the sural neurofasciocutaneous island flap along with lamellar muscle to improve the therapeutic effect. Method Since July 2004, based on the original design of sural neurofasciocutaneous island flap, we dissect the flap take along with lamellar muscle which thickness within 0.5 cm to 1.5 cm, and is smaller than the surface area of the flap. 9 cases have been treated with this method, proximal pedicle 2 cases, distal pedicle 7 cases, soft tissue defect with exposed bone and joint accompanied infection 4 cases, chronic osteomyelitis with dead space 2 cases, leg fracture with internal fixation stuff nudity 2 cases, inferior segment of tibia fracture with bone defect 1 case. Maximum flap 18 cm-12 cm, minimum flap 12 cm×7 cm, pedicle length 4-7 cm, pediele width 2.5-4 cm. Results Cross-section of the lamellar muscle taken along with the flap bleeding actively, with bright red color. All flaps survived completely and the wounds healing synchronized. All cases were followed up from 2 months to 2 years, outline satisfied, and function well. Conclusion Blood supply of the neuroadipofascial pedicled based sural nerve island myofascialcutaneous flap is reliable and the lamellar muscle improve the its anti-infection ability, it＇s profit for the healing of bone infection and fracture. This type of flap has little injury, and the operation is easy, so it＇s an effective method in repairing the above special cases.

关 键 词：腓肠神经 肌筋膜皮瓣 修复 

分 类 号：R622[医药卫生—整形外科]