携带腓肠神经的腓动脉终末支穿支筋膜皮瓣修复中前足皮肤缺损  

Repair the midfoot and forefoot skin defect by perforator fasciocutaneous flap of the terminal branch of peroneal artery carrying sural nerve

作　　者：汪帅 陈佳 杨涛 成贝贝 侯志慧 幸超峰 周明武 WANG Shuai;CHEN Jia;YANG Tao;CHENG Bei-bei;HOU Zhi-hui;XING Chao-feng;ZHOU Ming-wu(Dept of Trauma Microsurgery,the 988th Hospital of Joint Logistic Support Force of CPLA,Zhengzhou,Henan 450000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院创伤显微外科,河南郑州450000

出　　处：《临床骨科杂志》2021年第4期519-522,共4页Journal of Clinical Orthopaedics

基　　金：河南省卫健委医学科技攻关计划联合共建项目(编号:LHGJ20200793)。

摘　　要：目的探讨携带腓肠神经的腓动脉终末支穿支筋膜皮瓣修复中前足皮肤缺损的临床疗效。方法采用携带腓肠神经的腓动脉终末支穿支筋膜皮瓣修复13例中前足皮肤缺损患者。缺损面积8 cm×4 cm~18cm×8 cm,皮瓣设计面积9 cm×4 cm~19 cm×9 cm。结果12例皮瓣顺利成活,皮瓣质地良好,外观臃肿不明显,伤口一期愈合;1例皮瓣远端局部坏死,经换药后瘢痕愈合。移植皮片均成活。患者均获得随访,时间3~18个月。末次随访采用AOFAS中足评分标准评价疗效:优6例,良5例,可1例,差1例,优良率11/13。结论切取携带腓肠神经的腓动脉终末支穿支筋膜皮瓣修复中前足皮肤缺损,可不损伤腓动脉主干,还可进一步降低旋转点,操作相对简单。Objective To investigate the clinical effect of repairing the midfoot and forefoot skin defect by perforator fasciocutaneous flap of the terminal branch of peroneal artery carrying sural nerve.Methods The 13 cases of the midfoot and forefoot skin defects were repaired by perforator fasciocutaneous flap of the terminal branch of peroneal artery carrying sural nerve.Defect area was 8 cm×4 cm~18 cm×8 cm;designed flap area was 9 cm×4 cm~19 cm×9 cm.Results The 12 cases survived successfully,the shape of flaps had good texture,and the appearance was bloated and not obvious,the wounds healed by first intention;1 case had local necrosis at the distal end of the flap,the wound healed after dressing changing treatment.All the skin grafts of flaps survived well.All patients were followed up for 3~18 months.All cases were assessed by the American Orthopaedic Foot and Ankle Society(AOFAS)middle foot scoring standard.The results were excellent in 6 cases,good in 5,fair in 1 and poor in 1,with the excellent and good rate of 11/13.Conclusions The perforator fasciocutaneous flap of the terminal branch of peroneal artery carrying sural nerve is one of the effective method to repair the midfoot and forefoot skin defect,without damaging the main trunk of peroneal artery,the flap of rotation point can be further reduced and the operation is relatively simple.

关 键 词：足皮肤缺损 腓肠神经 腓动脉穿支 终末支 筋膜皮瓣 修复 

分 类 号：R622.1[医药卫生—整形外科] R658.3[医药卫生—外科学]