顺行腓肠神经营养血管皮瓣修复小腿上段胫骨外露创面的临床应用  

Anterograde sural neurovascular flap for repairing tibia exposed in the upper calf

作　　者：张丽轩 沈国良[1] 黄春辉[1] 韩未 侯佳敏 孙阳 Zhang Lixuan;Shen Guoliang;Huang Chunhui;Han Wei;Hou Jiamin;Sun Yang(Department of Burns and Plastic Surgery,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院烧伤整形科,江苏苏州215000

出　　处：《创伤外科杂志》2021年第1期53-55,共3页Journal of Traumatic Surgery

基　　金：国家自然科学基金(31370968)。

摘　　要：目的探讨顺行腓肠神经营养血管皮瓣修复小腿上段胫骨外露创面的疗效。方法回顾性分析2017年11月—2019年12月苏州大学附属第一医院烧伤整形外科收治小腿上段胫骨外露患者12例,男性9例,女性3例;年龄20~64岁,平均41.5岁;道路交通伤4例,机械伤3例,碾压伤2例,撕脱伤3例。创面面积5cm×4cm~9cm×3cm。合并胫骨骨折6例,创面均采用顺行腓肠神经营养血管皮瓣修复。结果皮瓣全部成活10例,皮瓣切取面积6cm×5cm~19cm×7cm;皮瓣远端边缘部分坏死2例,经换药后愈合。术后随访2~8个月,平均4.5个月。皮瓣外形满意,痛觉、触觉恢复较满意。结论顺行腓肠神经营养血管皮瓣修复小腿上段胫骨外露创面手术操作简单、不牺牲知名血管腓动脉,疗效满意,值得临床推广应用。Objective To investigate the therapeutic effect of anterograde sural neurovascular flap in repair of tibia exposed in the upper calf.Methods From Nov.2017 to Dec.2019,12 patients with tibia exposed in the upper calf who were treated in our hospital were analyzed retrospectively.There were 9 males and 3 females,with an average age of 41.5 years(20-64 years).There were 4 cases of road traffic injury,3 cases of mechanical injury,2 cases of crush injury and 3 cases of avulsion injury.The wound area was 5cm×4cm-9cm×3cm.All cases were treated by anterograde sural neurovascular flap and 6 cases of them had a fracture of the tibia.Results All the flaps survived in 10 cases and the area of flap was 6cm×5cm-19cm×7cm.The distal edge of the flap was necrotic in 2 cases,which healed after dressing change.All cases were followed up for 2-8 months postoperatively,with an average time of 4.5 months.The appearance,pain sensation and tactile sensation of the flap were satisfactory.Conclusion Anterograde sural neurovascular flap can be an optimal and worth spreading reconstruction method for repairing tibia exposed in the upper calf with simple operation and no sacrifice of peroneal artery.

关 键 词：皮瓣修复 胫骨外露 小腱 腓肠神经 创面修复 

分 类 号：R658.3[医药卫生—外科学]