足部逆行血管蒂皮瓣修复前足皮肤缺损

Treatment of forefoot cutaneous defect with retrograde foot vascularized flap transposition

目的 探讨足逆行血管蒂皮瓣修复前足皮肤缺损的效果。方法 足底内侧皮瓣以足底内侧动脉浅支为蒂逆行转移,足踝背皮瓣以足背动脉分支第一或第二跖背动脉为蒂逆行转移。转移皮瓣均行浅静脉及皮神经吻合修复。结果 转移皮瓣全部成活。其中 1例未行浅静脉吻合术后出现静脉危象,经减张及药物治疗后存活。术后 1年随访皮瓣感觉功能恢复。结论 足部逆行血管蒂皮瓣转移修复前足皮肤缺损,具有手术简捷、创伤小、功用好、并发症少等优点。

Objective To investigate the repair of forefoot cutaneous defect with retrograde foot vascularized flap.Methods The medial plantar flap was transpositioned with the superficial branch of medial plantar artery as pedicle.The retrograde dorsal foot flap was transpositioned with the 1st or 2nd branch of dorsal artery of foot as pedicle.The flaps transposition was performed with superficial venous and cutaneous nerve anastomosis.Results All flaps survived.One case without superficial venous anastomosis got venous crisis and survived after relief incision and medicine administration. In 1 year follow-up,the flaps got sensory function recovery.Conclusions It is simple,minimally invasive with good function recovery and less complication in the repair of forefoot cutaneous defect with retrograde foot vasclarized flap transposition.