结扎小隐静脉及重建腓肠感觉神经的逆行腓肠神经营养血管皮瓣修复足部软组织缺损  

Ligation of the small saphenous vein and reconstruction of sural sensory nerve to repair tissue defect of foot with retrograde sural neurovascular flap

作　　者：刘辉 杨勇 黄华凤 陆国通 罗文方 徐月忠 杜红敏 谢欢 林鹏 

机构地区：[1]贵阳市南明区人民医院创伤显微外科,贵州贵阳550002 [2]贵阳手足骨科医院手足外科,贵州贵阳550003

出　　处：《实用手外科杂志》2014年第3期255-258,共4页Journal of Practical Hand Surgery

基　　金：贵阳市卫生局立项课题（项目编号：筑卫发（2011）736号）

摘　　要：目的 探讨结扎小隐静脉及重建腓肠感觉神经的逆行腓肠神经营养血管皮瓣修复足软组织缺损的临床疗效.方法 采用结扎小隐静脉及重建腓肠感觉神经的逆行腓肠神经营养血管皮瓣修复足部软组织缺损23例,皮瓣面积：10.0 cm×12.0 cm～12.0 cm×18.0 cm.结果 本组随诊3～36个月,其中21例全部成活,一期愈合;1例皮瓣远端边缘部分坏死,经局部清痂换药后创面愈合;1例术后3d皮瓣局部出现张力性水疱,经抬高患肢、皮瓣远端放血疗法、应用脱水剂,一周后好转,再次游离植皮愈合.术后皮瓣质地良好,外观恢复满意,皮瓣两点辨别觉5～8 mm.负重良好,无溃疡再次发生.结论 结扎小隐静脉及重建腓肠感觉神经的逆行腓肠神经营养血管岛状皮瓣修复足部软组织缺损,皮瓣成活率高,感觉恢复好,不损伤主要血管.Objective To investigate the clinical effect of the ligation of the small saphenous vein and the reconstruction of sural sensory nerve to repair tissue defect of foot with retrograde sural neurovascular flap.Methods 23 cases of tissue defect of foot were repaired with retrograde sural neurovascular flap of the reconstruction of sural sensory nerve and ligation of the small saphenous vein.The flaps were approximately 10.0 cm×12.0 cm～12.0 cm×18.0 cm.Results Followed up from 3 to 36 months,21 cases flaps survived with primary healing in 23 cases; partial necrosis happened in the distal end of flap,after debridement and dressing change wound healed in one case.The local flap appeared tension blisters after 3 days in one case,after lifted the limb,used bloodletting in the distal end of flap,and applied dehydrating agent,improved after one week.Free skin graft to heal again.After the surgery,the texture of the flaps and appearance were excellent and two point discrimination was 5 to 8 mm.Weight-bearing good,no ulcer from happening again.Conclusion Ligation of the small saphenous vein and reconstruction of sural sensory nerve to repair tissue defect of foot with retrograde sural neurovascular flap,flap survival rate is high,feeling good recovery,and it need no damage to major blood vessels.

关 键 词：腓肠神经逆行皮瓣 小隐静脉结扎 腓肠神经 感觉重建 

分 类 号：R622.1[医药卫生—整形外科]