游离移植腓肠内侧动脉穿支皮瓣修复拇甲瓣供区缺损  

The free transplantation of medial sural artery perforatoRflap foRrepairing the wrap-around flap donoRskin defect

作　　者：林传甫 林加豪[1] 吕建敏[1] 朱其[1] LIN Chuan-fu;LIN Jia-hao;Lü Jian-min;ZHU Qi(Dept of Hand Sungery,the People′s Hospital of Ruian City,Ruian,Zhejiang 325200,China)

机构地区：[1]瑞安市人民医院手外科,浙江瑞安325200

出　　处：《临床骨科杂志》2022年第2期215-218,共4页Journal of Clinical Orthopaedics

基　　金：浙江省瑞安市科技局社会发展项目(编号:MS2019011)。

摘　　要：目的探讨游离移植腓肠内侧动脉穿支皮瓣修复拇甲瓣供区缺损的疗效。方法采用游离移植腓肠内侧动脉穿支皮瓣修复11例拇甲瓣供区缺损患者。缺损面积2.0 cm×2.0 cm~4.5 cm×3.0 cm。皮瓣设计面积3.0 cm×3.0 cm~5.0 cm×3.5 cm。小腿皮瓣供区直接缝合。结果患者均获得随访,时间2~10个月。移植皮瓣均顺利成活,创面一期愈合,无血管危象、感染等并发症发生。移植皮瓣耐磨性良好,术后6周行走无溃疡发生,不影响行走。末次随访时患趾外观良好,质地柔软,皮瓣色泽与健侧皮肤相似,无明显臃肿、畸形。小腿供区留线性瘢痕,下肢血运良好,皮肤红润,张力正常,无疼痛、怕冷。患者对皮瓣转移结果均较满意。结论采用游离移植腓肠内侧动脉穿支皮瓣修复拇甲瓣供区缺损,拇趾外观功能良好,供区损伤小,是拇甲瓣供区创面修复的有效方法。Objective To investigate the clinical effects of the free medial sural artery perforatoRflap foRthe repaiRof the wrap-around flap donoRskin defect.Methods The 11 cases of the wrap-around flap donoRskin defects were treated by the transplantation of free medial sural artery perforatoRflap.The defected wound size ranged from 2.0 cm×2.0 cm to 4.5 cm×3.0 cm,the designed flap size ranged from 3.0 cm×3.0 cm to 5.0 cm×3.5 cm.The calf flap donoRsite was sutured directly.Results All patients were followed up foR2~10 months.The grafted flaps survived smoothly,the wound healed in one-stage,and there were no complications such as vasculaRcrisis and infection.The weaRresistance of the transplanted flap was good,and there was no ulceRat 6 weeks afteRoperation,and didn′t affect the walking.At the last follow-up,the appearance of the affected toe was good,the texture was soft,the coloRof the flap was similaRto that of the healthy side,and there was no obvious swelling and deformity.The donoRarea only remained a lineaRscar,the donoRlimbs had good blood circulation,ruddy skin and normal tension,without pain and cold.All the patients were satisfied with the result of flap thansfer.Conclusions Using the free medial sural artery perforatoRflap to repaiRthe skin defect of the wrap-around flap donoRarea,preferably preserve the appearance and function of the toe,reduce the injuries of honoRarea,which is an ideal method foRrepairing toenail flap donoRarea wound.

关 键 词：指损伤 穿支皮瓣 拇甲瓣 游离皮瓣 显微外科 

分 类 号：R681.7[医药卫生—骨科学] R658.2[医药卫生—外科学]