应用腓肠内侧动脉穿支皮瓣修复四肢皮肤软组织缺损  

Repair of skin and soft tissue defects in extremities with medial sural artery perforator flap

作　　者：秦夏冰 姚忠军[1] 文科 吴潇潇 张小龙 刘海涛 QIN Xia-bing;YAO Zhong-jun;WEN Ke;WU Xiao-xiao;ZHANG Xiao-long;LIU Hai-tao(Department of Hand and Microsurgery,Affiliated Taihe Hospital of Hubei Universtiy of Medicine,Hubei Province,442000,China)

机构地区：[1]湖北医药学院附属太和医院手显微外科,湖北十堰442000

出　　处：《中国医疗美容》2023年第12期29-32,共4页China Medical Cosmetology

基　　金：湖北省卫健委科研基金(NO:HBJG-220065);十堰市科技局引导项目(NO:22Y36)。

摘　　要：目的 总结应用腓肠内侧动脉穿支皮瓣(MSAPF)修复四肢皮肤软组织缺损的临床疗效。方法 2019年1月至2021年1月,应用腓肠内侧动脉穿支皮瓣修复四肢皮肤软组织缺损创面16例,其中男12例、女4例,年龄18~70岁,平均45岁。重物砸伤2例、机器冲压伤4例、车祸伤4例、足部肿瘤切除术后创面1例、胫骨平台骨折术后钢板外露1例、踇甲瓣供区创面2例、电锯切割伤2例,其中足部5例、手部5例、小腿3例、膝关节2例、腕关节1例,游离移植14例、带蒂转位2例。皮瓣切取面积4.0 cm×5.0 cm~18.0 cm×9.5 cm,15例供区直接闭合,1例行供区植皮。术后观察皮瓣成活情况、外观、感觉,以及供受区外观功能情况,定期随访。结果 术后16例皮瓣均成活。15例皮瓣供区直接缝合,1例供区植皮,供受区创面均一期愈合。术后随访6~18个月,平均9个月,皮瓣外观良好,质地柔软,厚度适中,耐磨、无破溃,两点辨别觉7.0mm~12.0mm,供区无明显功能障碍。结论 腓肠内侧动脉穿支皮瓣不损伤主干血管,血管蒂长,穿支恒定,皮下脂肪少,供区损伤小,是修复四肢中小面积皮肤软组织缺损的理想选择之一。Objective To summarize the clinical effect of medial sural artery perforator flap(MSAPF)in repairing skin and soft tissue defects of extremities.Methods From January 2019 to January 2021,16 cases of skin and soft tissue defects of extremities were flrepaired with the perforator flap of the medial sural artery,including 12 males and 4 females,aged 18 to 70 years,with an average age ffiof 45 years.There were 2 cases of heavy object injury,4 cases of machine punching injury,4 cases of traffic accident injury,1 case of flfoot tumor resection wound,1 case of exposed plate after tibial plateau fracture,2 cases of donor site tissue defect of toenail flap,2 cases of electric saw cutting injury,including 5 cases of foot,5 cases of hand,3 cases of calf,2 cases of knee joint,1 case of wrist joint,fl14 cases of free transplantation,2 cases of pedicled transposition.Skin flap cutting area 4.0 cm×5.0 cm~18.0 cm×9.5 cm,15 donor flsites were closed directly,and 1 donor site was grafted.The survival,appearance,sensation of the flap and the appearance and function of the donor recipient area were observed and followed up regularly.Results flAll 16 flaps survived.15 cases were directly sutured in flthe donor area,and 1 case was grafted in the donor area.Follow up for 6 to 18 months(average 9 months)showed that the skin flap had good appearance,soft texture,moderate thickness,wear resistance,no ulceration,two-point discrimination of 7.0mm to 12.0mm,and no obvious dysfunction in the donor area.Conclusion flThe medial sural artery perforator flap does not damage the main blood vessels,with long vascular pedicle,constant perforator,less subcutaneous fat and less damage to the donor site.It is one of the ideal options for repairing small and medium-sized skin and soft tissue defects in the extremities.

关 键 词：腓肠内侧动脉 穿支皮瓣 修复 皮肤缺损 

分 类 号：R658[医药卫生—外科学]