腓动脉穿支蒂腓肠神经营养血管皮瓣修复足踝部创面  

Repaire the soft tissue defect in the ankle and foot with sural neurocutaneous vascular flap

作　　者：彭辉煌[1] 吴建伟[1] 余雪梅[1] 杨国敬[1] 邱海胜[1] 张凌洲[1] 

机构地区：[1]温州医学院附属第三医院,浙江瑞安325200

出　　处：《中医正骨》2011年第2期29-31,35,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨超声检查在诊断梨状肌综合症的诊断价值。方法:对26例临床确诊为梨状肌综合症的患者,应用B探讨和研究腓动脉穿支腓肠神经营养血管逆行岛状皮瓣修复足踝部创面的临床方法和疗效。采用腓动脉穿支腓肠神经营养血管逆行岛状皮瓣修复足踝部创面46例,男33例,女13例,年龄16~70岁。交通创伤致软组织缺损23例,机器压伤12例,重物压伤5例,烧烫伤3例,糖尿病足2例,其他1例。缺损位于踝部20例,足跟部10例,足部16例。皮肤缺损范围5 cm×3.5 cm^18 cm×10 cm;39例采用腓动脉穿支供血的腓肠神经营养血管皮瓣修复创面,7例采用肌皮瓣修复创面及骨髓炎。结果:46例病例术后均得到随访,随访时间3~12个月,46例皮瓣均存活,部分坏死2例,予以清创、游离植皮后创面愈合良好;边缘坏死6例,予以创口换药3~9周后创面愈合;皮瓣臃肿8例,术后3~9个月行皮瓣修整术后外形满意。结论:腓动脉穿支腓肠神经营养血管逆行岛状皮瓣具有血液供应可靠,对组织损伤小,不需要显微外科技术,皮瓣外形美观,是修复足踝部软组织缺损的理想皮瓣。Objective To study the operative techniques and clinical results for reconstruction the defect of ankle and foot with sural neurocutaneous vascular flap pedicled on the perforating branch of peroneal artery.Methods：From Jan.2006 to 2010,46 patients（33 males and 13 females,aged 16~70years） with soft tissue defect in heel and foot were treated,including 23 cases of soft tissue defect caused by traffic accident,12 cases by machine,5 cases by falling heavy objects,2 cases by diabetes mellitus,the other 3 by burning and one by other cause,the soft tissue defect of 20 patients occurred in ankle,10 patients occurred in heel and 16 in foot,the size of soft tissue defect from 5cm×3.5cm to 18cm×10cm,39 patients reconstructed the soft tissue with sural neurocutaneous vascular flap,7 patients with myofasciocutaneous flap.Result：All the flaps survived trough the postoperative follow-up（range 3 to 12 months）,the partly necrosis occurred in one patients and margin necrosis occurred in 4 patients,the occurred in 3 patients and obtained the normal texture through plasty sugery.Conclusion：The sural neurocutaneous vascular flap pedicled on the perforating branch of peroneal artery is ideal flap for reconstruction the defect in the ankle and foot for reliable supplyment,limited microsurgery techniques and without sacrificing a major vessel to the foot.favorable functional and asthetic results can obtained from this kind of flap.the major complications and donor-site morbidity frequent occurred.

关 键 词：腓肠神经 外科皮瓣 足踝 修复 

分 类 号：R658.3[医药卫生—外科学]