腓肠神经营养血管蒂逆行岛状皮瓣改进法修复足跟严重冻伤

The reverse flow island flap nourished by sural nerve nutrition blood vessel for repair of severe frostbite of feet

目的证实采用腓肠神经营养血管蒂逆行岛状皮瓣改进方法修复足跟部严重冻伤的可行性。方法在主皮瓣近端再设计一个纵轴长6.5～7cm的三角形辅助皮瓣,用以覆盖皮瓣转位后蒂部创面。结果13例21足皮瓣全部成活。术后随访5～18个月,皮瓣外形和功能满意,无溃疡发生。结论本术式有助于防止蒂部受压,保证皮瓣血运,是修复足跟部深度冻伤创面的较理想方法。

Objective The study was to verify the feasibility of an improved method using reverse flow island flap nourished by the sural nerve nutrition vessel to repair severe frostbite of feet. Methods At the proximal end of the principal flap, an auxiliary triangular skin flap of 6.5～7 cm in length was designed in order to cover the pedicle of the principal flap. This operation was performed on 13 patients (21 feet) with frostbite. Results All the flaps survived well. Postoperative follow-up for 5～18 months demonstrated satisfactory results in all the cases. No ulcer happened. Conclusions The method is helpful to prevent constriction of the pedicle and ensure blood supply of the flap. It is an ideal treatment for severe frostbite of feet.