腓浅动脉单一穿支微型皮瓣游离移植修复手足部皮肤缺损  

Superficial peroneal artery＇s singleness perforator flaps transfer to repair skin and soft defect of hands and feet

作　　者：江长青[1] 孟繁斌[1] 张建[1] 邱健钊[1] 桂先革[1] 徐贵升[1] 

机构地区：[1]北京大学深圳医院显微手外科,广东省深圳市5108036

出　　处：《中华显微外科杂志》2012年第2期104-106,I0006,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨腓浅动脉单一穿支微型皮瓣的临床疗效，并对手足部较小面积的皮肤软组织缺损进行定点修复。方法自2009年11月至2011年1月，共对8例（左足1例，右足1例，左手3例，右手3例）皮肤软组织缺损面积为（1．3cm×5．0cm～2．5cm×6．0cm）的患者进行腓浅动脉单一穿支微型皮瓣游离移植手术；依据术前查阅相关解剖文献，在小腿外侧中部，以腓骨小头与外踝连线为轴线，该轴线中点为腓浅动脉穿支部位，依据皮肤缺损区大小及形状设计皮瓣，并对皮瓣的设计、切取、皮瓣与受区的血管吻合、成活特点及治疗效果进行分析。结果8例手足部皮肤软组织缺损应用面积为1．5cm×5．2cm～2．8cm×6．2cm的腓浅动脉单一穿支微型皮瓣进行修复后均成活．外形、质地均满意，术后功能恢复效果良好；1例术后出现水疱、暗紫、脱痂后成活；1例术后皮瓣存活顺利，但出现指骨骨髓炎，经治疗愈合。结论腓浅动脉单一穿支微型皮瓣游离移植可对手足部较小的皮肤软组织缺损进行精确的定点修复，临床效果满意。Objective To explore the clinical efficacy of minitype vascularized superficial peroneal artery＇s singleness perforator flap , and then to accurately repair skin and soft tissue defects of hands and loots. Methods From November 2009 to January 2011, eight cases （one case of left foot, one case of right foot, three cases of left hand and 3 cases of fight hand, 1.3 cm×5.0 cm - 2.5 cm × 6.0 cm of skin and soft tissue defects）were treated by minitype vascularized superficial peroneal artery＇s singleness perforator flap. Based on preoperative applied anatomy papers, it was the superficial peroneal artery＇s perforator position in the middle of the lateral lower leg to the fibula head; We designed the flap based on the size and shape of skin defect, and then to analysize the flap design, lap cut, he vascular anastomosis of flap and recipient, effect and characteristics of survival. Results All the flaps（1.5 cm × 5.2 cm-2.8 cm× 6.2 cm） survived and satified in shape and texture, they acquired good functional recovery postoperation; There was blister, dark purple but survival after the scab off on 1 patient; There was phalanx ostomyelitis and healed after treatment on 1 patient. Conclusion The clinical effects were satisfactory for repairing small skin and soft tissue defect of hands and foots by minitype vascularized superficial artery＇s singleness perforator flap.

关 键 词：腓浅动脉 皮肤缺损 穿支皮瓣 

分 类 号：R658.3[医药卫生—外科学]