改良腓肠神经营养血管皮瓣修复足背软组织缺损  

Sural nerve vascular flap with anastomosing lesser saphenous reconstruct defect of dorsalis foot

作　　者：于凤宾[1] 吴水培[1] 俞立新[1] 黄飞[1] 

机构地区：[1]中国人民解放军第98医院南京军区显微骨科中心,浙江湖州313000

出　　处：《实用手外科杂志》2008年第3期155-157,共3页Journal of Practical Hand Surgery

摘　　要：目的总结吻合小隐静脉的远端蒂腓肠神经营养血管皮瓣修复足背软组织缺损的经验,探讨本术式皮瓣的血循环特点、成活机制及术中注意事项。方法对2003年10月—2007年6月采用吻合小隐静脉的远端蒂腓肠神经营养血管皮瓣修复足背软组织缺损20例的病例资料进行回顾性分析,该20例足背均为不同程度的软组织缺损,术中将皮瓣近端小隐静脉与受区大隐静脉或其属支吻合。结果20例术后皮瓣均成活,无静脉回流障碍等并发症发生。仅1例远端部分坏死,经换药后愈合。术后随访6个月～4年,足部外形良好,皮瓣质地、色泽与周边相似,足功能恢复良好。结论吻合小隐静脉改善了腓肠神经营养血管皮瓣静脉回流,为皮瓣建立了通畅的静脉回流系统,改变了皮瓣血液循环模式,扩大了皮瓣的修复范围及能力,可使皮瓣向肢端延伸,能够修复足背远端软组织缺损,为临床修复足中远端软组织缺损提供了一种新方法。Objective To sum up the chnical with anastomosing lesser saphenous, discuss experience of distally-based sural blood circulation characteristic, nerve vascular flap kernel of operative mode and survive mechanism.Methods The data of 20 patients of parenchyma defect of dorsalis pedis were retrospectively reviewed, who were all repaired by distally-based sural nerve vascular flap with anastomosing lesser saphenous to great saphenous or its branches in recipient site during operation.Results All 20 flaps survived. The blood supply and venous return of the skin flaps were good.1 case was partly necrosis in distal end of flap, and healed through dressing change.the 20 cases were followed up 6 months to 4 years.The shape of the flaps were satisfactory. The texture and color and luster of the flaps were similar to the adjacent skin.The functions of feet were good. Conclusion The method of anastomosing lesser saphenous improved the venous return of sural nerve vascular flap, changed blood circulation mode of flap,enlarged scope and abihty of flap rehabilitation, enabled to repair defect of dorsalis forefoot, for renovation of parenchyma defect in dorsalis pedis, offered a new method for renovation of parenchyrna defect of dorsalis foot.

关 键 词：外科皮瓣 小隐静脉 移植 静脉回流 

分 类 号：R658.3[医药卫生—外科学]