接力腓肠外侧动脉穿支螺旋桨皮瓣修复逆行腓肠神经皮瓣供区  

Reconstruction of the donor area of distally based sural flap with relaying lateral gastrocnemius artery perforator propeller flap

作　　者：宋达疆[1] 李赞[1] 周晓[1] 池征璘[2] 周鑫 

机构地区：[1]湖南省肿瘤医院肿瘤整形外科,长沙410008 [2]温州医科大学第二附属医院手外科,浙江温州325027 [3]西南医科大学附属中医医院手外科,四川泸州646600

出　　处：《中国修复重建外科杂志》2017年第11期1363-1366,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：湖南省自然科学基金面上项目(13JJ5012);湖南省科技计划项目(2014SK3002);湖南省卫生和计划生育委员会课题项目(B2014-111)~~

摘　　要：目的探讨接力腓肠外侧动脉穿支螺旋桨皮瓣修复逆行腓肠神经皮瓣供区的临床疗效。方法 2014年1月—2016年1月,收治12例足踝部皮肤软组织缺损患者。男10例,女2例;年龄14~52岁,平均23.4岁。轮辐伤7例,交通事故伤5例。左足7例,右足5例。创面范围10 cm×4 cm^12 cm×6 cm。病程2~84 h,平均26.2 h。采用逆行腓肠神经皮瓣修复创面,供区采用接力腓肠外侧动脉穿支螺旋桨皮瓣移位修复;腓肠神经皮瓣切取范围为11 cm×5 cm^13 cm×7 cm,腓肠外侧动脉穿支螺旋桨皮瓣切取范围为7 cm×4 cm^10 cm×6 cm。结果术后所有皮瓣均顺利成活,供、受区创面均Ⅰ期愈合;未发生血管危象、切口裂开和明显肿胀等情况。12例均获随访,随访时间6~14个月,平均12.4个月。皮瓣供区仅遗留线性瘢痕,小腿功能未见明显影响,颜色及外观轮廓自然。结论接力腓肠外侧动脉穿支螺旋桨皮瓣修复逆行腓肠神经皮瓣供区,能避免小腿供区植皮,减小供区损伤,是修复足踝部皮肤软组织缺损的较好选择之一。Objective To investigate the clinical application of relaying lateral gastrocnemius artery perforator flap in reconstruction of the donor defect after distally sural flap transferring. Methods Between January 2014 and January 2016, 12 cases with foot and ankle defects were treated. There were 10 males and 2 females with an average age of23.4 years（mean, 14-52 years）. The injury was caused by motorcycle accident in 7 cases and traffic accident in 5 cases. The injury located at left limb in 7 cases and right limb in 5 cases. The size of soft tissue ranged from 10 cm×4 cm to 12 cm×6 cm. The disease duration was 2-84 hours（mean, 26.2 hours）. The foot and ankle defects were reconstructed by distally sural flaps, then the flap donor sites were reconstructed with relaying lateral gastrocnemius artery perforator flap at the same stage. The size of distally sural flap ranged from 11 cm×5 cm to 13 cm×7 cm. The size of relaying flap ranged from7 cm×4 cm to 10 cm×6 cm. Results All flaps survived uneventfully. All recipient sites and donor sites healed smoothly.No vascular crisis, wound dehiscence, or evident swelling occurred. All patients were followed up 6-14 months（mean,12.4 months） with satisfied esthetic and functional results in recipient and donor sites. There were only linear scar on the donor sites. The color and contour was satisfying, the function of calf and foot were not affected. Conclusion The relaying lateral gastrocnemius artery perforator flap combined with distally sural flap is an idea choice to reconstruct foot and ankle defect, which can avoid donor site skin grafting, minimize donor site morbidity.

关 键 词：足踝部缺损 腓肠神经皮瓣 腓肠外侧动脉 接力皮瓣 创面修复 

分 类 号：R658.3[医药卫生—外科学]