携带胭动脉穿支蒂的腓肠神经营养血管皮瓣修复小腿中上段软组织缺损  

The anterograde sural neurovascular flap based on the popliteal artery perforator for covering tissue defects in middle and distal upper leg

作　　者：周廷玉 喻爱喜[1] 张友 钟斌 杜俊生 陈金 郭双红 

机构地区：[1]武汉大学中南医院显微骨科,武汉430071 [2]宜昌市夷陵医院骨科

出　　处：《中华显微外科杂志》2016年第5期428-431,共4页Chinese Journal of Microsurgery

基　　金：武汉市黄鹤英才项目（2014）

摘　　要：目的探讨应用腘动脉穿支蒂腓肠神经营养血管皮瓣修复小腿中上段软组织缺损的临床效果。方法2011年12月至2015年9月，收治18例小腿中上段软组织缺损患者，采用腘动脉穿支蒂腓肠神经营养血管皮瓣修复创面。其中男12例，女6例，年龄24~55岁，平均35.9岁，缺损面积3.0 cm × 3.0 cm^7.0 cm × 9.0 cm。致伤原因：慢性溃疡4例，车祸伤3例，重物砸伤3例，胫骨上段骨折术后并发组织坏死8例。结果18例皮瓣全部成活，1例皮瓣边缘感染，经换药愈合，其余伤口均一期愈合。随访3~16个月，平均9个月，成活皮瓣无明显臃肿，皮瓣质地、色泽良好，厚度适中，感觉部分恢复两点辨别觉4.0~10.0 mm。结论腘动脉穿支蒂腓肠神经营养血管皮瓣血供可靠，不损伤主要血管，皮瓣质地良好且操作简单，是修复小腿中上段软组织缺损的一种较好方法。Objective To evaluate the clinical effect of popliteal artery perforator-based sural neurovascular flap for repairing soft tissue defects in middle and distal upper leg. Methods Between December, 2011 to September, 2015, 18 cases with skin soft tissue defects on the middle and distal upper leg were treated with popliteal artery perforator-based sural neurovascular flap, in which 12 cases were males, and 6 cases were females. The age was from 24 to 55 years, with the average age of 35.9 years. The size of tissue defects ranged from 3.0 cm ×3.0 cm to 7.0 cm × 9.0 cm. Results All flaps survived completely in 18 cases, 1 case of marginal infection heated after dressing, and the rest cases in I healing. The outline and function of survived flap were satisfactory during 3-16 months follow-up, with two-point discrimination of 4.0-10.0 mm. Conclusion The anterograde sural neurovascular flap based on the popliteal artery perforator provides a practical option for covering tissue defects in middle and distal upper leg. This flap is characteristieed by reliable blood supply without sacrificing main vesses, good contour and texture, in addition, the operation is easy of handling.

关 键 词：小腿 腘动脉穿支 腓肠神经营养血管皮瓣 软组织缺损 显微外科手术 

分 类 号：R658.3[医药卫生—外科学]