大隐静脉-隐神经营养血管蒂逆行岛状皮瓣的临床应用

Clinical application of the reversed great saphenous vein-saphenous neurocutaneous vascular pedicle island flap

目的探讨大隐静脉-隐神经营养血管蒂逆行岛状皮瓣修复足踝部软组织缺损的临床应用。方法2002年5月-2006年1月，对26例踝关节周围及足背软组织缺损患者行大隐静脉-隐神经营养血管蒂逆行岛状皮瓣转移修复术。皮瓣面积最大为14cm×7cm，最小为6．5cm×5．5cm，平均9．3cm×6．1cm；蒂长3～7cm，蒂宽3～4cm，表面均保留1．5～2cm宽的皮桥行明道转移。结果25例皮瓣成活，随访6～18个月，皮瓣质地满意；1例皮肤坏死，但皮下组织部分存活。经游离皮片移植后创面愈合良好。结论大隐静脉-隐神经营养血管蒂逆行岛状皮瓣是修复下肢远端软组织缺损的一种良好方法。

Objective To explore the clinical application of the reversed great saphenous veinsaphenous neurocutaneous vascular pedicel island flap in repairing the soft tissue defect of the distal lower extremity. Methods From May 2002 to January 2006, 26 cases of soft tissue defect in the ankle and dorsal foot were treated with the reversed great saphenous vein-saphenous vascular pedicel island flap. The areas of transferred flaps were 14 cm × 7 cm at maximum and 6.5 cm × 5.5 cm at minimum （9.3 cm×6.1 cm on average）. The pedicel was 3-7 cm in length and 3-4 cm in width, with 1.5- 2 cm-wide skin bridge reserved to transfer through the open tunnel. Results They were followed up for 6-18 months. The flaps survived in 25 cases, with satisfactory flap texture. Skin necrosis happened in only one case in which partly vital subcutaneous tissue was found and sound healing was obtained by free skin graft. Conclusion The reversed great saphenous vein-saphenous neurocutaneous vascular pedicel island flap is a good way of repairing the soft tissue defect of the distal lower extremity.