腓肠内侧动脉穿支皮瓣在同侧下肢中小面积皮肤软组织创面修复中的临床应用  

Clinical application of medial sural artery perforator flap in the repair of small and medium size skin and soft tissue wounds of ipsilateral lower limbs

作　　者：范涌熙 Guy Romeo Kenmegne 余游 段阿林 尹一杰 方跃[1,2] FAN Yongxi;Guy Romeo Kenmegne;YU You;DUAN Alin;YIN Yijie;FANG Yue(Department of Orthopedic Surgery,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Trauma Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Restorative and Reconstructive Department,NO.1 Orthopedics Hospital of Chengdu,Chengdu,Sichuan 610074,P.R.China)

机构地区：[1]四川大学华西医院骨科,成都610041 [2]四川大学华西医院创伤医学中心,成都610041 [3]成都第一骨科医院修复重建科,成都610074

出　　处：《华西医学》2023年第10期1461-1467,共7页West China Medical Journal

摘　　要：目的探讨腓肠内侧动脉穿支皮瓣应用于同侧下肢中小面积皮肤软组织缺损创面修复的临床疗效。方法回顾性分析2021年9月—2023年1月成都第一骨科医院修复重建科收治的下肢中小面积皮肤软组织缺损患者临床资料。收集患者基本信息,并术后记录切取皮瓣解剖特点、使用方式、临床结果以及末次随访采用皮瓣综合疗效评价表评估临床疗效。结果共纳入患者13例。其中,男12例,女1例。13例患者切取皮瓣内共发现19条腓肠内侧动脉穿支,平均1.46条。皮瓣切取范围5.5 cm×3.5 cm~13.5 cm×5.0 cm。顺行带蒂转移3例,游离移植10例;使用嵌合皮瓣5例,分叶皮瓣1例,其余7例为常规穿支皮瓣。术后皮瓣全部顺利成活。13例患者均获随访,随访时间4~15个月,平均(10.38±3.64)个月。13例患者的皮瓣疗效综合评分77~92分,平均(86.76±4.45)分;其中5例评级为优,8例评级为良,优良率为100%。结论腓肠内侧动脉穿支皮瓣具备的多功能性特点和灵活的使用方法增加了同侧下肢中小面积创面的修复方法,并且可以获得更佳的美学修复效果。Objective To investigate the therapeutic effect of medial sural artery perforator flap in the repair of small and medium size skin and soft tissue defects in the ipsilateral lower extremities.Methods The clinical data of patients with small and medium area skin and soft tissue defects of lower limbs admitted to Restorative and Reconstructive Department,NO.1 Orthopedics Hospital of Chengdu between September 2021 and January 2023 was retrospectively analyzed.Basic information of patients was collected.The anatomical characteristics,application methods,and clinical results of the flap were recorded after operation,and the comprehensive efficacy evaluation table of the flap was used to evaluate the clinical efficacy at the last follow-up.Results A total of 13 patients were included.There were 12 males and 1 female.A total of 19 perforating branches of medial sural artery were found in the 13 cases,with an average of 1.46 perforating branches.The incision range of the flap was 5.5 cm×3.5 cm−13.5 cm×5.0 cm.Anterograde pedicle metastasis occurred in 3 cases and free transplantation occurred in 10 cases;mosaic flaps were used in 5 cases,lobed flaps in 1 case,and conventional perforator flaps in the remaining 7 cases.All the flaps survived successfully.All the 13 patients were followed up for 4-15 months,with an average of(10.38±3.64)months.The comprehensive score of flap efficacy was 77-92 points,with an average of(86.76±4.45)points.Among them,5 cases were excellent,8 cases were good,and the excellent and good rate was 100%.Conclusion The multifunctional features and flexible use of medial sural artery perforator flap increase the repair strategy of small and medium-sized wounds of the ipsilateral lower limbs,and can obtain better aesthetic repair results.

关 键 词：腓肠内侧动脉穿支皮瓣 下肢皮肤软组织缺损 创面修复 

分 类 号：R622[医药卫生—整形外科]