内踝上逆行岛状筋膜皮瓣修复足踝部皮肤软组织缺损

Repair of skin and soft tissue defect around the malleolus by superior regressive island fasciocutaneous skin flap graft

目的:探讨足踝部皮肤软组织缺损并骨外露或跟腱外露的修复方法。方法:应用内踝上逆行岛状筋膜皮瓣转移修复13例由车祸外伤、疤痕溃疡、肿瘤等所致的足踝部皮肤软组织缺损并骨外露或跟腱外露。修复皮肤软组织缺损最大面积6cm×14cm,跟骨外露最大面积5cm×10cm。结果:共切取内踝上逆行岛状筋膜皮瓣13块,其中1例岛状筋膜皮瓣术后坏死,行游离背阔肌肌皮瓣移植修复愈合,其余内踝上逆行岛状筋膜皮瓣及供瓣区所植皮片均完全成活,术后随访6月～4年,效果满意。结论:内踝上逆行岛状筋膜皮瓣移植是修复足踝部皮肤软组织缺损并骨外露或跟腱外露的理想方法之一。

Objective To discuss the repairing procedure of skin and soft tissue defect around the malleolus, achilles tendon exposure, or calcaneus tendon exposure by superior regressive island fasciocutaneous skin flap graft. Methods We used the superior regressive island fasciocutaneous skin flaps to repair 13 cases of skin and soft tissue defect or achilles tendon exposure around malleolus after trauma, scar ulcer, tumor, or other occasions. The maximal size of skin and soft tissue defect was 6 cm × 14 cm. The maximal size of calcaneus exposure was 5 cm × 10 cm. Results Twelve cases obtained complete success with satisfactory results, and 1 case of necrosis delayed wound healing by latissimus dorsal myocutaneous flap graft. The follow-up lasted from 6 months to 4 years with satisfactory results. Conclusion The superior regressive island fasciocutaneous skin flap graft is an effective and convenient method to repair skin and soft tissue defect around the malleolus, achilles tendon exposure, or calcaneus tendon exposure.