扩展的小腿前外侧逆行岛状皮瓣的临床研究  

Clinical appfication of the extended reverse anterolateral leg flap

作　　者：路来金[1] 宫旭[1] 宣昭鹏[1] 刘彬[1] 于家傲[1] 陈雷[1] 崔健礼[1] 孙希光[1] 路璐[1] 

机构地区：[1]吉林大学第一医院手外科,长春130021

出　　处：《中华显微外科杂志》2009年第5期360-362,共3页Chinese Journal of Microsurgery

摘　　要：目的探讨应用小腿前外侧皮瓣的双重血供对可扩大皮瓣切取面积及提高旋转应用范围的可行性。方法在应用解剖学研究的基础上，设计以腓浅动脉和外踝上动脉为血管蒂的双重供血小腿前外侧逆行岛状皮瓣，临床应用60例。皮瓣切取面积最大26．0cm×7．0cm、蒂长6．0cm，最小16．0cm×10．0cm、蒂长8．0cm，旋转轴点均在外踝前。结果皮瓣全部成活53例，占88．3％；大部分成活7例，占11．7％。术后随访6个月～3年，皮瓣在术后1年后出现保护性感觉，患者恢复行走功能。结论保留小腿前外侧供区的双重血供来源，可扩大小腿前外侧皮瓣的供血范围及切取面积，以此为包括前足的大面积足部软组织缺损的修复提供了可行性。Objective To introduce the clinical application of the extended anterolateral leg flap, which is based on the superficial peroneal artery and lateral supramalleolar artery. Methods Through anatomic study on the blood supplies of the skin over the anterolateral portion of the leg, The combined su- perficial peroneal artery and lateral supramalleolar artery could extend the size of the traditional anterolateral leg flap. In addition, the point of pivot of the extended anterolateral leg flap could locate at the level of the lateral malleolus, which decreases the distance between the flap and recipient site. Clinically, we have used the extended anterolateral leg flaps in 60 patients to cover skin defect over the feet. The flap ranged from 16 cm×10 cm （pedicle length 8.0 cm） to 26 cm × 7 cm （pedicle length 6.0 cm）. Results In the series, the flap survived in 53 patients （88.3%） unevently, and partial necrosis occurred in 7 patients （11.7%）. Conclusion Based on the combined superficial peroneal artery and lateral supramalleolar artery, the size of the traditional anterolateral leg flap could be iuceased, which enlarges its value on the coverage of skin defects over the feet.

关 键 词：外科皮瓣 小腿 腓浅动脉 外踝上动脉 移植 显微外科技术 

分 类 号：R658.3[医药卫生—外科学]