改良腓肠神经营养血管皮瓣修复足踝部软组织缺损的疗效观察

Efficacy Observation on Reforming Sural Neurovascular Flap for Repair of Soft Tissue Defect of Ankle and Foot

目的:探讨改良腓肠神经营养血管皮瓣修复足踝部软组织缺损的疗效价值。方法:应用改良腓肠神经营养血管逆行皮瓣修复足踝部面积较大的累及前足的软组织缺损16例。蒂部的宽度减少至2cm,蒂部的旋转点下降至外踝上2cm。面积过大的创面采用腓肠神经营养血管逆行岛状皮瓣加游离皮瓣联合移植。术中创面彻底清创,防止坏死组织继发感染影响皮瓣成活。结果:术后12例皮瓣全部成活,其中2例皮瓣远端边缘部分坏死,经换药后愈合。结论:改良腓肠神经营养血管逆行岛状皮瓣可以减少皮瓣切取时的组织损伤;将皮瓣的应用范围延伸到前足;扩大皮肤缺损修复的面积,是修复足踝部皮肤软组织缺损的重要手段之一,对于足踝部乃至前足的皮肤软组织缺损的修复具有重要的临床意义。

Objective：To explore the value on the improved sural flaps soft tissue defect. Methods：The reformed sural neurovascular reversed flap was used to repair 36 cases of soft tissue defect of ankle and foot. Pedicle width decreased to 2cm, rotation points of pedicle was descended to the lateral malleolus 2cm. The wound area that is too large must be combined transplantation with reversed sural neurovascular island flap and free flap. To prevent secondary infection of necrotic tissue affected flap survived, the wound must be debrided thoroughly during surgery. Results：36 cases of flaps all survived, besides, two of the flaps＂ distal edge mortified, but healed after dressing.Conclusion：By Improving the sural nerve nutrition blood vessel retrograde island flap when the flap can reduce the tissue damage; to extend the flap to the dorsum of the foot or the foot of the remote; to expand the area of skin defect; the improved method blood supply reliable, high survival rate, procedure is simple, does not damage the well-known advantages of important blood vessels and nerves are repaired ankle and foot soft tissue defects is one important means for the ankle and even before the foot of the skin and soft tissue defects has important clinical significance.