远端蒂腓肠神经营养血管皮瓣修复足踝部软组织缺损  

作　　者：石波[1] 王军[1] 唐诗天[1] 杨衡[1] 康斌[1] 王陶[1] 

机构地区：[1]四川省绵阳市中心医院骨科,621000

出　　处：《当代医学》2012年第32期7-9,共3页Contemporary Medicine

摘　　要：目的评价远端蒂腓肠神经营养血管皮瓣修复足踝部软组织缺损的临床疗效。方法回顾研究2005年5月～2012年7月在四川省绵阳市中心医院行远端蒂腓肠神经营养血管皮瓣修复足踝部软组织缺损的37例(男27例,女10例)患者,年龄18～49岁,平均33.4岁;软组织缺损范围3.5cm×3.0cm～10.0cm×6.5cm,切取皮瓣范围6cm×5cm～11cm×8cm,皮瓣血管蒂长6～15cm,蒂宽3～5cm。追踪随访其疗效。结果术中观察切取的皮瓣边缘渗血活跃,血运良好。所有患者均获随访,平均随访时间5.5个月(1～60个月),皮瓣均存活,外观无明显臃肿。1例皮肤边缘坏死,2例感染,所有患者供区均无明显不适。35例(91.89%)伤口Ⅰ期愈合,肌皮瓣质地优,外形满意,大部分恢复感觉,行走及负重良好。结论远端蒂腓肠神经营养血管皮瓣修复足踝部软组织缺损手术操作简单,成功率高,是修复足踝部中小面积软组织缺损的理想供区。Objective To evaluate the efficacy of the distally based sural neuro-veno-fasciocutaneous flap for reconstruction of foot and ankle soft tissue defects. Methods A retrospective study was designed. From May 2005 to July 2012,thirty seven patients with soft tissue defects on malleolus and foot were resurfaced with distally based sural neuro-veno-faseiocutaneous flap,including 27 males and 10 females with an average age 33.4 years （range, 18-49 years）.The pivot point was approximately 5cm above the tip of lateral malleolus, the size of soft tissue defects ranged from 3.5cm×3.0cm to 10.0×6.5 cm, the flaps were designed with the size measuring 6cm×5cm to 11 cm×8cm. Preoperative data,postoperative results and complications were recorded, all patients were followed up in out patient＇s department. Results The side of the distally based sural neuroveno-faseiocutaneous flap was errhysising actively and the skin flap was good circulation duing operation. All patients were followed up for one to sixty months （average five and a half months）,37 flaps survived completely except marginal necrosis was seen in one and infection in another two. There was no considerable morbidity on donor site for all patients. Incision of 34 flaps （91.89%） healed primarily, the flaps were satisfactory in appearance,feel recovered and walk well. Conclusion Our experience demonstrated that distally based sural neuro-veno-fasciocutaneous flap were effective to repair the small and medium soft tissue defects on malleolus and foot, this sural flap with a thin perforator pedicle could be feasiblely rotated,this flap has high survival rate,the surgical technique was simple and easy to succeed, this flap has high survival rate.

关 键 词：腓肠神经营养血管皮瓣 软组织缺损 修复重建 

分 类 号：R658.3[医药卫生—外科学]