腓肠神经营养血管蒂逆行岛状筋膜皮瓣的临床应用  

Clinical application of reversed sural neurovascular fasciocutaneous island flap for reconstruction of soft-tissue defects

作　　者：李虎山[1] 郝平[1] 张辉[1] 徐凯[1] 尚燕[1] 

机构地区：[1]山西医科大学第二临床医学院整形科,太原030001

出　　处：《山西医科大学学报》2008年第1期67-69,共3页Journal of Shanxi Medical University

摘　　要：目的探讨带腓肠神经营养血管蒂逆行岛状筋膜皮瓣修复小腿下段及足踝部软组织缺损的可行性与有效性。方法对21例小腿下段及足踝部软组织缺损的病例,采用带腓肠神经营养血管蒂逆行岛状筋膜皮瓣为主配合植皮的治疗方法进行局部创面修复。皮瓣面积最大15cm×10cm,最小8cm×6cm。结果术后皮瓣血运良好,未见血管危象,19例成活。2例皮瓣远端部分坏死伴水泡形成,经清创换药愈合。所有软组织缺损均修复,肌腱、骨骼外露均覆盖。随访3个月-3年,转移后皮瓣质地优良,外观及功能满意,有部分感觉恢复。结论腓肠神经营养血管岛状筋膜皮瓣是修复小腿中下段、踝部、足跟部、足背侧中部近端软组织缺损的理想方法。Objective To explore the feasibility and validity of repairing soft tissue defects in enemis, ankle and foot with reversed sural neurovascular fasciocutaneous island flap. Methods Twenty-one cases of soft tissue defects around the heel,malleolus, achilles tendon and the low 1/3 part of anterior tibial were reconstructed by reversed sural neurovascular fasciocutaneous island flaps. The sizes of the flap ranged from 8 cm × 6cm to 15 cm × 10 cm. Results The flaps totally survived in 19 patients, the distal part necrosed in 2 cases. All soft tissue defects were repaired. All accompanied bone and tendon exposure healed. Their appearance and function were satisfactory after an average of a year follow-up （ranged from three months to three years）. The texture of the flaps were excellent. The sensation of the flaps recovered in different degree. Conclusion This kind of flap has advantages of reliable blood supply, convenient design and the character of avoidance of the major arteries. It is satisfactory in repairing the soft tissue defects around the heel, malleolus, achilles tendon and the low 1/3 part of anterior tibial.

关 键 词：腓肠神经 营养血管 外科皮瓣 软组织缺损 修复 

分 类 号：R622[医药卫生—整形外科]