穿支蒂腓浅神经营养血管皮瓣修复外踝部皮肤缺损  

Perforator-based neurocutaneous vascular flap of superficial peroneal nerve for ankle reconstruction

作　　者：秦毅[1,2] 江建明[1] 秦杰[2] 

机构地区：[1]南方医科大学南方医院脊柱骨病科,广州501515 [2]广东省中医院珠海医院骨二科,广东珠海519020

出　　处：《中国临床解剖学杂志》2011年第3期343-345,349,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的报道利用穿支蒂腓浅神经营养血管皮瓣修复对外踝部皮肤软组织缺损。方法利用便携式多普勒超声仪,在创缘周围探测腓动脉发出的穿支,以其中最合适的穿支为旋转点及血管蒂,沿腓浅神经轴线切取穿支蒂皮瓣逆向转位修复外踝部伴有肌腱及骨外露的创面。结果本组9例,男6例,女3例;年龄20～45岁,平均32岁;皮肤软组织缺损面积为3 cm×5 cm～7 cm×11 cm;皮瓣切取面积为4 cm×6 cm～8 cm×12 cm。皮瓣存活良好,颜色正常,修复效果好。平均随访两个月,患者步态正常,无疼痛,但其中2例患者抱怨小腿外侧区及足背有麻木感。结论穿支蒂腓浅神经营养血管皮瓣设计灵活,切取方便,血供可靠,适于修复外踝部的皮肤软组织缺损创面,是一种皮神经营养血管皮瓣与穿支蒂皮瓣相结合的优良皮瓣。Objective To report the perforator-based neurocutaneous nutritional flap of the superficial peroneal nerve for covering soft-tissue defects around the lateral malleolus.Methods The portable Doppler ultrasound was employed to locate the perforators from the peroneal artery,and the most appropriate one was adopted as the vascular pedicle;based on this perforator,the retrograde perforator-based neurocutaneous nutritional flap of the superficial peroneal nerve was harvested for coverage of soft-tissue defects around the lateral malleolus complicated by exposure of the tendon and the bone,with its axis based on the direction of the nutritional plexus of the superficial peroneal nerve.Results 9 cases were included in this group,with 6 of them being male,3 of them being female;their ages fell between 20 and 45 years old,with an average of 32 years old.The size of the defect ranged from 3cm×5 cm to 7cm×11cm,and the size of the flap ranged from 4cm×6 cm to 8cm×12 cm.All flaps survived well,with excellent color and reparative outcome.After an average 2-month follow-up,all patients were pain-free and can ambulate with normal gaits.Conclusions The perforator-based neurocutaneous nutritional flap of the superficial peroneal nerve is a versatile flap that can be manipulated to resurface the complicated soft-tissue defects around the lateral malleolus.It is a pliable flap with a reliable blood supply and an optimal combination of the perforator flap and the neurocutaneous nutritional flap.

关 键 词：腓浅神经 穿支蒂皮瓣 外踝 修复 

分 类 号：R622.1[医药卫生—整形外科]