摘要
目的探讨应用小腿远端不同穿支蒂皮神经营养血管皮瓣修复小腿下段和足踝部软组织缺损的适应证和临床效果。方法对24例小腿下段和足踝部软组织缺损的患者，优选5种不同的小腿远端穿支蒂皮神经营养血管皮瓣进行修复，其中腓动脉外踝后上穿支蒂腓肠神经营养血管皮瓣7例，外踝后穿支筋膜蒂腓肠神经营养血管皮瓣2例，腓动脉高位穿支蒂腓肠神经营养血管皮瓣2例，腓动脉外踝前上穿支蒂腓浅神经营养血管皮瓣8例，胫后动脉内踝上穿支蒂隐神经营养血管皮瓣5例。皮瓣切取面积为5cm×4em～14em×12cm。结果除了1例腓动脉外踝前上穿支蒂腓浅神经营养血管皮瓣发生远端部分坏死之外，其余皮瓣术后均顺利成活，切口均一期愈合。15例患者获得1～36个月的随访，皮瓣色泽、质地及厚薄较为满意，供、受区外形与功能恢复也较为满意。结论根据小腿下段和足踝部软组织缺损的具体情况，并结合小腿远端不同穿支蒂皮神经营养血管皮瓣的特点，选择最适宜的皮瓣加以修复，多能以供区最小的代价获得最佳的受区效果。
Objective To investigate the clinical application of different perforator neurofasciocutaneous flaps at the distal legs for defects at the lower legs and feet. Methods 24 patients with defects at the lower legs and feet were treated with five kinds of perforator neurofasciocutaneous flaps, including 7 flaps with the retrolateral supramalleolar cutaneous perforator, 2 flaps with the lateral retromalleolar perforator, 2 flaps with the higher cutaneous perforator of the peroneal artery, 8 flaps with the anterolateral supramalleolar cutaneous perforator of the peroneal artery, 5 flaps with the medial supramalleolar cutaneous perforator of the posterior tibial artery. The flap size ranged from 5 cm × 4 cm-14 cm × 12 cm. Results Partial necrosis occurred at the distal end of flap in one case. All the other flaps survived completely with primary healing. 15 eases were followed up for 1-36 months with satisfactory cosmetic and functional results. Conclusions Suitable perforator neurofascioeutaneous flaps at the distal legs can be selected for differently located defeets at the lower legs and feet, leaving comparatively less morbidity at donor site.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2012年第5期344-346,共3页
Chinese Journal of Plastic Surgery
关键词
外科皮瓣
皮神经营养血管
小腿
Surgical flaps
Neurofasciocutaneous
Lower leg
