腓动脉终末穿支皮瓣修复足踝部皮肤软组织缺损  

Peroneal artery terminal perforator flap for coverage of soft tissue defects in foot and ankle

作　　者：袁超群 顾加祥 王天亮 冯清波 刘宏君 YUAN Chaoqun;GU Jiaxiang;WANG Tianliang(Department of Hand and Foot Surgery,Clinical Medical College,Yangzhou University,Yangzhou,Jiangsu,225001,China)

机构地区：[1]扬州大学临床医学院苏北人民医院手足外科,江苏扬州225001 [2]南京医科大学,江苏南京211100 [3]大连医科大学,辽宁大连116044

出　　处：《实用手外科杂志》2021年第4期433-435,450,共4页Journal of Practical Hand Surgery

基　　金：江苏省苏北人民医院2019年度院级科研资助重点项目(项目编号:yzucms2018904)。

摘　　要：目的探讨采用腓动脉终末穿支(即外踝后间隙穿支)皮瓣修复足踝部皮肤软组织缺损的可行性和临床疗效。方法2017年1月-2019年11月,应用腓动脉终末穿支皮瓣修复足踝部皮肤软组织缺损7例。以超声多普勒确定外踝后间隙腓动脉穿支的穿出部位,以邻近创缘的穿支为旋转点,设计腓动脉终末穿支皮瓣,充分利用切取的皮瓣组织修复创面。结果7例皮瓣全部成活,创面均一期愈合。其中1例出现静脉危象,经换药引流后危象消失。术后随访6~17个月(平均11个月),皮瓣色泽佳、质地良好、外形满意,穿鞋不受影响,踝关节活动无受限,均无需二期修薄。结论应用腓动脉终末穿支皮瓣修复足踝部创面可获得理想的治疗效果,值得临床推广应用。Objective To introduce a modified technique to reconstruct soft tissue defects in foot and ankle by using the peroneal artery terminal perforator flap(the lowest perforating branch of the peroneal in the posterior compartment artery of lateral malleolus),and to report the effectiveness of the modified technique.Methods Between January 2017 to November 2019,7 patients with soft tissue defects in the foot and ankle were treated with the peroneal artery terminal perforator flap.Ultrasound was used to determine the perforating site of the peroneal artery.The lowest perforating branch adjacent to the wound margin was used as the rotation point to design the peroneal artery perforator flap.100%of the flap tissue was used to repair the wound.Results One case had venous crisis,however no urgent operative revision was performed.All of 7 flaps survived completely.The grafted skins at donor site survived,and primary healing of incision was obtained.The follow-up period was 6 to 17 months(mean,11 months).In the follow-up,all of the flaps provided good contours,good texture,no significant bloated appearance,with no limitation of the ankle's range of motion.Surgeries for thinning the flaps were not necessary.All of the patients were satisfied with the cosmetic and functional result.Conclusion The peroneal artery terminal perforator flap provides satisfied clinical results,it is a useful and reliable technique for coverage of soft tissue defects in foot and ankle in clinical application.

关 键 词：足踝部 腓动脉 穿支皮瓣 终末 外踝后间隙 

分 类 号：R658.3[医药卫生—外科学]