腓肠神经营养血管皮瓣的临床应用  

Clinical application of skin flap supplied by sural nerve nutrition blood vessel

作　　者：张兴群[1] 郑俊[1] 陈四木[1] 金伟强[1] 袁见华[1] 

机构地区：[1]杭州市余杭区第一人民医院,311100

出　　处：《浙江临床医学》2004年第3期175-176,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨腓肠神经营养血管皮瓣逆行转移修复足背、足跟及踝部软组织缺损 ,交腿转移修复对侧足踝部缺损的临床应用效果。方法 在应用解剖基础上 ,设计带筋膜蒂的腓肠神经营养血管岛状皮瓣 ,逆行应用修复足背、足跟、足底及踝部软组织缺损 ,同时观察皮瓣的可切取范围、血液供应及静脉回流情况、营养血管在外踝上与腓动脉穿支相交通的位置及血管蒂隧道的处理方案。结果 临床应用21例 ,其中修复足背软组织缺损8例、足跟软组织缺损4例、足底软组织缺损2例 ,外踝及足背联合缺损3例及对侧足踝部软组织缺损4例。皮瓣最大面积15cm×9.5cm ,除2例远侧皮缘部分坏死 ,全部成活。结论 腓肠神经营养血管皮瓣血液循环丰富 ,成活率高 ,不牺牲主要血管神经 ,是修复足背、足跟、踝部及足底软组织缺损的理想皮瓣。Objective To explore the outcome in clinical application of repairing forefoot,heel and malleolus soft tissue defect by retrograde sural neurovascular flap and contralateral malleolus defect by cross-leg flap. Methods On the basis of anatomy,we devise a kind of fasciocutaneous island flap supplied by sural nerve nutrition blood vessel and displaced retrogradely to repair the forefoot,heel,sole and malleolus soft tissue defect.We also observe simultaneously the maximum available size of the flap,its blood supply and veinal backflow,the location where the nutrition blood vessel communicate with the perforating branch of the peroneal artery at the external malleolus,and the disposal of the tunnel which contains vascular pediˉcle. Results 21cases were treated with the method above-mentioned,including8cases of forefoot soft tissue defect,4cases of heel,2cases of sole,3cases of external malleolus combined with forefoot,and4cases of contralateral malleolus.The maximum size of the flap was15cm×9.5cm.All the flap survived except for partial necrosis of distal skin margin in23cases. Conclusion The blood supply of the sural neurocutaneous flap is ample and it does not sacrifice the main arteries.The survival rate of the flap is high.So it is a ideal one for repairing the soft tissue defect of forefoot,heel,malleolus and sole.

关 键 词：腓肠神经 营养血管皮瓣 临床应用 足踝部缺损 皮瓣移植 

分 类 号：R622[医药卫生—整形外科]