逆行供血的胸脐皮瓣游离移植修复胫骨外露创面  

REPAIRING OF SOFT TISSUE DEFECT IN LEG BY FREE VASCULARIZED THORACOUMBILICAL FLAP WITH REVERSED FLOW

作　　者：徐永清[1] 李主一[1] 李军[1] 郭远发[1] 汪新明[1] 阮默[1] 李俊辉[1] 

机构地区：[1]成都军区昆明总医院全军骨科中心,昆明650032

出　　处：《中国修复重建外科杂志》2000年第6期352-354,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　观察逆行供血的吻合血管胸脐皮瓣修复胫骨外露创面的临床效果。方法　对 44侧小腿动脉铸型标本进行了观测的基础上 ,于 1993年 5月～ 2 0 0 0年 7月 ,对临床收治的 2 5例小腿中上段大面积软组织缺损 ,胫骨外露 ,其中 18例有胫前或胫后血管长段受损栓塞 ,创面最大为 2 8cm× 11cm,最小为 11cm× 9cm。采用小腿远端胫前或胫后血管远端与腹壁下血管吻合的胸脐皮瓣移植修复创面。结果　胫前动脉、胫后动脉和腓动脉三组主干型血管 ,三者彼此间在足踝部交通吻合十分丰富 ,有很好的相互代偿能力。术后移植皮瓣全部成活 ,皮瓣色泽、质地良好 ,创面完全修复。结论　只要小腿胫前或胫后主要血管之一正常 ,受损血管远端正常 ,逆行供血良好 ,即可采用吻合血管的胸脐皮瓣修复小腿中上段大面积软组织缺损。s Objective To investigate the clinical effect of free vascularized thoracoumbilical flap with reversal flow in repairing the soft tissue defect in leg with tibia exposure. Methods Forty-four casting mould specimens of leg arteries were studied firstly. Then 25 cases with soft tissue defect and tibia exposure in the proximal-middle segment of leg were adopted in this study. Among them, 18 cases had long distance thrombosis of the anterior tibial vessels or posterior tibial vessels due to traumatic lesion. The maximal size of defect was 28 cm × 11 cm and the minimal size of defect was 11 cm × 9 cm. In operation, the thoracoumbilical flap which was based on the inferior epigastric vessels was anastomosed to the distal end of the anterior tibial vessels or posterior tibial vessels. Results Anterior tibial artery, posterior tibial artery and fibular artery had rich communication branches in foot and ankle. All the flaps survived, the color and cosmetic result of them were good. Conclusion The free vascularized thoracoumbilical flap with reversed flow is practical in repairing the soft tissue defect of leg with tibia exposure. Either the anterior tibial vessels or the posterior tibial vessels is normal, and the distal end of injured blood vessels is available, this technique can be adopted.

关 键 词：小腿创面 胸脐皮瓣 游离移植 

分 类 号：R658.3[医药卫生—外科学] R622.1[医药卫生—临床医学]