带感觉的游离足底内侧动脉深支穿支皮瓣修复足跟软组织缺损15例  

Sensorial free perforator flap of deep medial plantar artery in reconstruction of soft tissue defect in heel: a report of 15 cases

作　　者：李跃军 冯小辉 陈亚伟[1] 胡晓宇 李伟[1] 曹能力[1] 白晨平[1] LI Yuejun;FENG Xiaohui;CHEN Yawei;HU Xiaoyu;LI Wei;CAO Nengli;BAI Chenping(Department of Orthopedics,Zhengzhou Orthopaedic Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市骨科医院骨科,郑州450000

出　　处：《中华显微外科杂志》2024年第5期525-527,共3页Chinese Journal of Microsurgery

摘　　要：目的观察带感觉的游离足底内侧动脉深支穿支皮瓣修复足跟软组织缺损的临床效果。方法自2022年5月至2023年6月, 郑州市骨科医院骨科共收治15例足跟部软组织缺损患者, 男6例, 女9例;年龄21~45岁, 平均32岁。缺损面积5 cm×8 cm~10 cm×14 cm, 均采用带足底内侧神经皮支的游离足底内侧动脉深支穿支皮瓣进行修复, 皮瓣大小5 cm×8 cm~11 cm×14 cm。供区一期VSD敷料覆盖, 1周后拆除, 肉芽填满创面后行全厚皮片植皮。结果术后15例皮瓣成活。术后门诊随访8~15(平均12)个月, 足跟修复的外观、质地满意, 患足可正常负重, 无明显触痛, 无溃疡形成, 耐磨、耐寒冷, 皮瓣感觉较好, 皮瓣TPD达5~7 mm, 同时经过康复训练后皮瓣无异位感残留。无明显色素沉着及瘢痕挛缩。结论应用带感觉的游离足底内侧动脉深支穿支皮瓣修复足跟软组织缺损效果满意, 值得临床推广。Objective To observe the clinical effect of free perforator flap of deep medial plantar artery and with sensory nerve in reconstruction of soft tissue defect in heel.Methods From May 2022 to June 2023,a total of 15 patients with soft tissue defect of heels that caused by various reasons were admitted to the Department of Orthopedics,Zhengzhou Orthopaedic Hospital.The patients were 6 males and 9 females aged 21 to 45 years old,at 32 years old in average.The size of defects was 5 cm×8 cm-10 cm×14 cm.Free perforator flaps of deep medial plantar artery with cutaneous medial plantar nerve were used,at 5 cm×8 cm-11 cm×14 cm in size.Cover the first phase of VSD dressing in the supply site,remove it after 1 week,fill the wound with granulation tissue,and then perform full-thickness skin graft.Results All 15 flaps survived after surgery.Postoperative outpatient follow-up lasted for 8 to 15(average 12)months.Appearance and texture of the reconstructed heels were satisfactory,the affected feet were able to bear normal weight without obvious tenderness or ulcer formation.The reconstructed heals were resistant to wear and cold with good sensation.TPD of the flaps achieved 5 mm to 7 mm,without sense of heterotopia after rehabilitation.There was no obvious pigmentation or cicatricial contracture.Conclusion It is satisfactory to apply a free perforator flap of deep medial plantar artery with sensory nerve in reconstruction of soft tissue defect of heel.

关 键 词：足底内侧动脉深支 穿支皮瓣 足跟 软组织缺损 显微修复 

分 类 号：R622[医药卫生—整形外科]