摘要
目的:总结腓肠神经营养血管逆行岛状皮瓣修复足跟部皮肤恶性肿瘤切除后创面的临床经验。方法:自2000年6月—2010年6月对8例足跟部皮肤恶性肿瘤切除后的创面应用了腓肠神经营养血管逆行岛状皮瓣进行了修复。其中男性6例,女性2例;年龄38～67岁;肿瘤切除后创面大小:4.5 cm×5.0 cm～10.0 cm×12.0 cm;切取皮瓣面积:5.0 cm×6.0 cm～11.0 cm×13.0 cm;皮肤肿瘤性质:恶性黑色素瘤1例,基底细胞癌4例,鳞状细胞癌3例。所用皮瓣中有4例将小隐静脉与受区静脉进行了吻合,有3例将皮瓣中的腓肠神经近端与足跟创面内可见的皮神经进行了吻合。结果:术后皮瓣全部成活,术后3～7 d皮瓣肿胀明显,1周后肿胀逐渐减轻。吻合静脉的皮瓣术后肿胀程度轻于未吻合静脉皮瓣,吻合神经的皮瓣术后感觉恢复好于未吻合神经皮瓣。术后6～24个月随访6例患者,皮瓣形态良好,局部耐磨,术后1年均有感觉存在。结论:应用腓肠神经营养血管逆行岛状皮瓣修复足跟部皮肤恶性肿瘤切除后创面血供可靠,解剖方便,切取皮瓣面积大,对供区影响小,临床效果好;条件允许时,结合皮瓣静脉吻合、局部神经吻合,更有助于改善术后皮瓣血运和感觉恢复。
Objective： To summarize the clinical experiences of repair of the wound on the heel after removal of skin malignant tumor with the distally-based sural nerve nutritional blood vessel island flap. Methods： In 8 cases admitted from June 2000 to June 2010 the flap was used to cover the defect after removal skin malignant tumor. The size of the wound ranged from 4.5 crux 5.0 cm to 10.0 cm× 12.0 cm, the flap area ranged from 5.0 cm× 6. 0 cm to 11.0 cm× 13.0 cm. In 4 patients the flap wein was anastomosed to superficial wein of the wound. In 3 patients the nerves of the flap were anastomosed with the superficial nerve of the wound. Results： All 8 flaps survived, the flaps appeared obviously swollen after the operation for 3-7 days, then the swelling gradually subsided, but the degree of swelling in the 4 wein anastbmosis flaps was less than that of other flaps without wein anastomosis. The sensation of the 3 flaps with nerve anastomosis was better than that without nerve anastomosis. The fol- low-up observation in 6 cases after operation for 6-24 months showed that the appearance and function of the flap were satisfactory, the sensation of the flaps gradually recovered 1 year after the operation. Conclusion： Repair of the wound on the heel after removal of skin malignant tumor with the distally-based sural nerve nutritional blood vessel island flap has the advantages of good appearance, reliable blood supply, large size and little influence to the donor site. Anastomosis of superficial veins and nerve of the flap to the recipient site can improve the survival and the sensation recovery of the flap.
出处
《感染．炎症．修复》
2011年第2期104-106,共3页
Infection Inflammation Repair
关键词
皮瓣
恶性肿瘤
创面修复
Flap Malignant tumor Wound repair
