腓肠神经营养血管皮瓣的临床应用

Clinical Applications of Skin Flaps Supplied by Sural Nerve Nutrition Blood Vessel

目的探讨腓肠神经营养血管皮瓣的临床应用特点。方法应用腓肠神经营养血管皮瓣逆行、顺行或交腿转移修复小腿中下段及足踝部软组织缺损18例。结果本组术后皮瓣全部成活,蒂部及皮瓣供区均完全愈合,软组织缺损均修复。术后平均随访12(6～24)个月,20周时感觉功能评定:S28例,S2+6例,S34例;供体神经功能无明显影响。结论腓肠神经营养血管蒂恒定,变异极少,手术操作简单,动脉供血可靠,静脉回流充分,不牺牲主干动脉,供区损伤少,创面大部分可直接缝合,可重建感觉,皮瓣成活率高,是修复小腿中下段及足踝部创面的理想选择。

Objective To investigate the clinical characteristics of skin flap supplied by sural nerve nutrition blood vessel. Method 18 soft tissue middle and inferior segments of cnemis and heels were repaired by the flaps mentioned above by retrograd, antergrade, or cross-leg diversion. Results All the flaps inclu- ding pedicels survived, and the donor sites cured completely. After average 12 （6 -24） months follow-up, the movement and sense outcomes were S2 in 8 cases , S2^＋ in 6 cases and S3 in 4 cases. And the nerve function was not obviously destroyed in the donor sites. Conclusion Skin flaps supplied by sural nerve nutrition blood vessel have the advantages of permanent vessel pedicel, rare variation, easy operation, reliable artery supply, sufficient venous return, and no main artery excision. It is an ideal choice for repairing the middle and inferior segments of cnemis and heels with direct suture, sense reconstruction, and high survival rate.