逆行胭窝及小腿内后侧皮瓣修复胫前近段软组织缺损  

Method of repairing soft tissue defects in lateral tibial areas using reversed flap of popliteal fossa and posteromedial calf

作　　者：汉吉健 王家祥[1] 尹纪军[2] 魏书俊 刘祥礼 

机构地区：[1]山东省日照市中医医院骨科,276800 [2]山东省日照市人民医院骨科

出　　处：《中国医师进修杂志》2009年第11期4-6,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨修复胫前近段软组织缺损的适宜方法。方法采用逆行胭窝及小腿内后侧皮瓣修复胫前近段软组织缺损18例，其中骨外露13例、钢板外露5例。皮瓣切取大小6．5cm×4．0cm～12．5cm×7．0cm。结果18例胫前近段软组织缺损患者除1例术后发生浅表感染，经换药逐渐愈合外，皮瓣全部成活，均达到一期消灭创面，局部无功能受限，且受区的外形较好；供区打包植皮，全部成活，没有发现明显的供区功能障碍。所有患者随访3～12个月（平均8个月），皮瓣质地及外观均良好，功能恢复满意。结论逆行胭窝及小腿内后侧皮瓣具有血液供给可靠，皮瓣切取面积大，皮瓣较薄，局部转移距离短，易转移，易于切取等优点。适宜修复胫前近段皮肤软组织缺损，且在皮瓣的下方可切取腓肠肌内侧头并转移覆盖创面，对骨、钢板外露能起到预防感染及抗感染作用，故对胫前近段大面积皮肤软组织缺损伴骨及钢板外露是一种较好的修复方法。Objective To explore the method of repairing soft tissue defects in lateral tibial areas. Methods Eighteen cases of soft tissue defects in lateral tibial areas were repaired with reversed flap of popliteal fossa and posteromedial calf, 13 cases with tibia exposed, 5 cases with armor plate exposed. The sizes of the flap ranged from 6.5 cm × 4.0 cm to 12.5 cm × 7.0 cm. Results The patients were followed up from 3 months to 12 months, 17 flaps survived. Superficial infection occurred in 1 case which gradually healed after changing dressings. The flaps had fine appearance and function.They could eliminated surface of wound directly. Packed skin was grafted to donor site and survived completely without dysfunction. Conclusions It is a thin flap with large area. The flap has reliable blood supply and is easy to be cut and short-distance transferred. It is suitable for repairing lateral tibial soft tissue defects.Under the flap, cutting medial head of gastrocnemius to cover the surface of wound where bone and armor plate are exposed to prevent infection.So the flap is an effective method to repair lateral tibial defects with bone and armor plate exposed.

关 键 词：软组织损伤 外科皮瓣 胫前近段 

分 类 号：R65[医药卫生—外科学]