摘要
目的探讨吻合小隐静脉的腓肠神经营养血管逆行岛状皮瓣修复跟骨骨髓炎性跟部皮肤缺损的临床效果。方法对11例跟骨骨髓炎伴跟部皮肤缺损患者,行吻合小隐静脉的腓肠神经营养血管逆行岛状皮瓣移位修复,术中将皮瓣远端的小隐静脉与受区皮下静脉作端端吻合以改善静脉回流。皮瓣切取范围12 cm×15 cm^4 cm×6 cm,血管蒂长6~15 cm。结果10例皮瓣完全成活,创口一期愈合;1例术后因吻合的静脉栓塞致皮瓣远端部分坏死,创口二期愈合。11例获得6~24个月随访,皮瓣质地优良,恢复部份保护性感觉,外形及功能恢复满意。结论吻合小隐静脉的腓肠神经营养血管的逆行岛状皮瓣能有效增进皮瓣静脉回流、提高跟骨慢性骨髓炎伴皮肤缺损的修复效果。
Objective To investigate the clinical results of repairing the skin defects secondary to chronic calcaneal osteomyelitis using the distally based sural neurocutaneous flap by anastomosis of small saphenous vein. Methods 11 cases with composite skin defects of calcaneal region were repaired by the transposition of distally based sural neurocutaneous flaps. The flap area ranged from 12 cm × 15 cm to 4 cm×6 cm, the pedicle of the flap ranged from 6 cm to 15 cm in length. The small saphenous vein of the flap were anastomosed with the subcutaneous superficial vein of the recipient site to improve the venous drainage. Results The composite flap survived completely in 10 cases. One case was partially survived because of thrombosis in anastomosed veins postoperatively. All of the 11 cases were followed up for 6 to 24 months, the color and texture of the flap were excellent, the protective sensation were recovered, the configuration and function were satisfactory. Conclusions Because of the improvement of the venous drainage, anastomosis of small saphenous veins of the distally based sural neurocutaneous flaps with the subcutaneous superficial veins of the recipient site can significantly repair the skin defects secondary to chronic calcaneal osteomyelitis.
出处
《临床骨科杂志》
2006年第2期135-137,共3页
Journal of Clinical Orthopaedics
关键词
跟骨骨髓炎
皮神经
小隐静脉
外科皮瓣
皮肤/缺损
calcaneal osteomyelitis
neurocutaneous nerve
small saphenous vein
surgical flaps
skin/injuries
