小腿外侧皮瓣在足踝部创面修复中的应用  

Repair of Foot and Ankle Soft Tissue Defect with the Application of Ectocnemial Skin Flaps

作　　者：苗卫华[1] 

机构地区：[1]山东省菏泽市立医院,山东菏泽274000

出　　处：《中国医学创新》2013年第23期26-28,共3页Medical Innovation of China

摘　　要：目的:对小腿外侧皮瓣的切取进行改进并总结其在足踝部创面修复中的经验和技巧。方法:2004年7月-2012年7月,应用小腿外侧皮瓣逆行转移修复足踝部创面19例,游离移植修复足踝部创面6例。其中8例将皮瓣内感觉神经与创面内感觉神经进行吻合。皮瓣面积最大27cm×12cm,最小9cm×5cm。结果:术后皮瓣全部成活。其中1例出现动脉危象,经拆除蒂部缝线,局部注射利多卡因后危象解除。1例出现静脉回流障碍,经拆除蒂部缝线、抗凝、换药处理后成活良好。本组病例随访时间6个月～2年,皮瓣外形满意,质地耐磨,足踝部功能恢复好。吻合神经的皮瓣恢复部分保护性感觉。结论:小腿外侧皮瓣血管解剖恒定,厚薄适中,供区隐蔽,是修复足踝部创面的有效方法。Objective： To improve the method of ectocnemial skin flaps and summarize the experiences in the treatment of foot and ankle soft tissue defect. Method： From June 2002 to July 2012, 25 patients suffered soft tissue defect in foot and ankle were repaired with ectocnemial skin flaps, including 19 eases with vascular pedicle and 6 cases free.The sensation nerves in the flap and the recipient site were anastomosed.The flap area ranged from 9 cm x 5 cm to 27 em ~ 12 cm. Result： All flaps survived after operation. Insufficient arterial supply of flap occurred in 1 cases after operation, the pedicled incision sewing thread was removed and lidocain was injected around vascular pedicle, then the flap isehemia was released. Inadequate venous return and venous hyperemia occurred in 1 case and released after bloodletting.AU patients were followed up from 6 months to 2 years.The flap were with good shape, wear-resistant and with good function.The protective sensation recovered in the cases in which the nerves were anastomosed.Conchlsion： The eetocnemial skin flap is a reliable method to repair foot and ankle soft tissue defect with good shape and function.

关 键 词：小腿外侧皮瓣 足踝部 软组织缺损 修复 

分 类 号：R658.3[医药卫生—外科学]