外踝上动脉皮瓣修复足背组织移植供区缺损的临床研究  

Coverage of donor site defects on dorsum of the foot after dorsalis pedis flap transfer with pedicled lateral supramalleolar artery flaps

作　　者：李涛[1] 陈振兵[1] 翁雨雄[1] 丛晓斌[1] 艾方兴[1] 周攀[1] 洪光祥[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院手外科,武汉430022

出　　处：《中华手外科杂志》2014年第6期406-408,共3页Chinese Journal of Hand Surgery

摘　　要：目的 探讨外踝上动脉皮瓣带蒂逆行转移修复足背组织移植供区缺损的临床效果.方法 2008年10月至2012年9月,对11例手外伤其中6例行第二足趾加足背皮瓣游离移植,5例足背皮瓣移植的患者采用外踝上动脉皮瓣带蒂逆行转移,修复足背组织移植后供区缺损创面.术后对皮瓣外形满意度,痛触觉、温度觉、两点分辨觉及对患足功能行AOFAS评分.结果 术后11例皮瓣全部顺利存活,供区伤口均Ⅰ期愈合.9例获得12～ 24个月的随访,2例失访.皮瓣具有较好的外形,伤口愈合良好,无瘢痕、疼痛及破溃发生,患者对皮瓣外形满意,术后12个月皮瓣两点分辨觉平均为（10.1±2.2）mm,感觉评级为S3＋,患侧踝-足AOFAS评分平均为90.7分.结论 外踝上动脉皮瓣带蒂逆行转移是修复足背供区的一种较好的方法,可减少足背供区并发症,恢复足部的良好外形和功能.Objective To investigate the clinical application of pedicled for coverage of donor site defects resulted from dorsalis pedis flap transfer.Methods From October 2008 to September 2012,the flap pedicled on the lateral supramalleolar artery was reverse transferred to cover the defect on the dorsum of the foot resulted from dorsalis pedis flap harvest in 11 cases.Among these cases 6 had second toe combined with dorsalis pedis flap transfer and 5 had dorsalis pedis flap transfer.Postoperatively the appearance of the flaps,pain and touch sensation,temperature perception and two-point discrimination were evaluated.AOFAS assessment of donor foot function was performed.Results Flaps of the 11 cases all completely survived.Primary wound healing was achieved at the flap donor site.Nine cases were follow-up for 12 to 24 months while 2 were lost to follow-up.The flaps had good appearance.There were no excessive scar,pain or ulcer.The patients were satisfied with the aesthetic results.Perception of pain,temperature and touch was restored.At 12 months postoperatively,twopoint discrimination was （10.1 ± 2.2） mm on average.Sensory recovery was S3＋,while the mean foot and ankle AOFAS score was 90.7.Conclusion Reverse transfer of pedicled lateral supramalleolar artery flap is a good option for coverage of dorsum foot soft tissue defect.It reduces donor site morbidity and restores good appearance and function of the donor foot.

关 键 词：外科皮瓣 移植 供区 修复 

分 类 号：R658.3[医药卫生—外科学]