改良逆行腓肠神经营养血管皮瓣修复足踝部软组织缺损  

Improved Retrograde Sural Neurovascular Fasciocutaneous Flap for Repair of Soft Tissue Defects on Foot and Ankle

作　　者：崔彩清[1,2] 梁国伟[1,2] 邓雪峰[1,2] 

机构地区：[1]深圳龙华新区观澜医院 [2]广东医学院附属观澜医院骨科,深圳518110

出　　处：《中国现代手术学杂志》2013年第2期139-141,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨改良逆行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 2009年2月～2011年11月,采用分离腓动脉穿支最低肌间隔穿支或外踝后血管穿支,跟外侧血管穿支汇入腓肠神经营养血管最低点的血管穿支与腓肠神经营养血管组成联合蒂皮瓣逆行转移修复足踝部软组织缺损16例共16处。修补足部较远软组织缺损的皮瓣远端做成真皮下血管网皮瓣。结果 16例16处皮瓣全部成活。所有患者均获随访,随访时间平均22.5(12～39)个月,无并发症。14例皮瓣外形满意,2例皮瓣外形臃肿,予二期整形手术修薄皮瓣。所有移植皮瓣均无溃疡发生;有痛触觉,两点辨别觉4～9 mm;患肢步行正常。结论通过把穿支血管汇入腓肠神经营养血管最低点作为皮瓣联合蒂的皮瓣逆行转位,完成转移点下移,皮瓣仍能完好成活而且功能良好;同时满足了修复足部远端软组织缺损的需要;该术式简单易行,不需吻合血管,是修复足踝跟部软组织缺损比较理想的术式。Objective To assess the clinic effect of retrograde sural neurovascular fasciocutaneous flap to repair soft tissue defects of foot and ankle. Methods From February 2009 to November 2011, a total of 16 cases with soft tissue defect on foot and ankle were repaired with retrograde sural neurovascular flap. The u- nited pedicle flap was composed of perforation branch of peroneal artery or perforation branch behind ankle, perforation branch beside heel. End of the flap was made of the subdermal vascular plexus flap when defect area of foot and ankle located in distal area of the foot and ankle. Results All the 16 flaps in 16 patients sur- vived. All cases were followed up for 12 to 39 months with an average of 22.5 months. No complications were found. Except 2 cases were performed secondary plastic surgery because of swollen appearance of the flap, the other 14 cases （ 14 flaps） were achieved satisfactory effect in color and texture. The two point discrimination of the flap was 4 to 9 mm and the function recovery was satisfactory. Conclusions The improved retrograde su- ral neurovascular flap can achieve well survival and satisfactory function by moving down the transition point of flap through the wears vascular import sural nerve nutrient vessels of the lowest point as a retrograde transposi- tion flap ; at the same time it can meet the needs of foot soft tissue defects in distal. The operation is a simple and ideal procedure for repairing of soft tissue defect on foot and ankle without vascular anastomosis.

关 键 词：外科皮瓣 腓肠神经 软组织损伤 足损伤 踝损伤 

分 类 号：R658.3[医药卫生—外科学]