腓动脉踝上穿支腓肠神经营养血管皮瓣修复足部皮肤缺损  

Distal Perforator-Based Sural Neurocutaneous Flap For Treatment of Defect of Skin Soft Tissue on Foot

作　　者：陈国威 童仁联[2] 容伟超 伍娉娉 

机构地区：[1]广东省台山市人民医院,广东台山529200 [2]广州市红十字会医院暨南大学第四附属医院

出　　处：《中国伤残医学》2011年第2期5-7,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨应用带外踝上穿支腓肠神经营养血管皮瓣修复足部缺损,简化手术操作,改善皮瓣血供。方法:2006年6月～2010年3月,对11例足部皮肤缺损的病人应用带外踝上腓动脉穿支腓肠神经营养血管皮瓣修复。缺损面积范围:5cm×3cm9cm×9cm.其中男8例,女3例,最小年龄18岁,最人年龄62岁,平均年龄31岁,缺损原因:车祸5例,慢性感染性溃疡3例,肿瘤1例,缺损部位:足跟部4例,内踝部2例,足背部3例;手术彻底清创后或切除肿物后,以胭窝中点与外踝尖跟腱中点连线为轴,以外踝上腓动脉穿支处为旋转点设计皮瓣。皮瓣蒂部设计3cm～4cm宽的筋膜蒂及2cm～3cm宽的皮桥。手术先切开蒂部后缘至深筋膜下,确认外踝上穿支,切开上缘及内外侧缘,在深筋膜下向蒂部分离皮瓣,通过明道将皮瓣转移至受区。供瓣区创面直接缝合或植皮修复。结果:11例足部皮肤缺损病例修复后,皮瓣全部成活。但有8例术后足外侧感觉麻木。结论:带外踝上穿支腓肠神经营养血管皮瓣结合了穿支皮瓣及皮神经营养血管皮瓣的优点,具有操作简便,蒂部较长,血供丰富。是修复足部皮肤缺损,特别是前足皮肤缺损可供选择的一种方法。Objective：To explore the method of the distal perforator-based sural nemvcutaneou flap to replace defect of skin soft tissue on foot and simplify the operative procedure. Methods： From June 2006 to March 2010, 11 cases Of defects Of skin soft tissue on foot were repaired by distal perforator-based sural neurotaneou flaps .The area of detect ranged 5cm × 3cm to 9cm × 9cm. of 11 cases, 3 were femal and 8 were male, whose age ranged from 18 to 62. Results： All of the eleven flaps survived well, Without obvious infection . Conclusion：The distal perforator-based surgical neurocutaneus flap for treatment of defect of skin soft tissue on foot might a simple and reliable technzque which have advantage over the perforator flap and the flap

关 键 词：足 皮肤缺损 穿支 腓肠神经 外科皮瓣 带蒂转移 

分 类 号：R683[医药卫生—骨科学]