应用内踝上逆行皮瓣修复足踝部皮肤软组织缺损

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

目的观察应用内踝上逆行皮瓣修复足踝部皮肤软组织缺损并骨外露或跟腱外露的效果。方法自2000年来应用内踝上逆行皮瓣27例，转移修复由车祸外伤、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皮瓣27块，其中血管蒂逆行皮瓣9例，筋膜血管蒂逆行皮瓣12例，带部分皮肤的筋膜血管蒂逆行皮瓣6例。其中1例皮瓣术后坏死，行游离背阔肌肌皮瓣移植修复愈合，其余逆行皮瓣及供瓣区所植皮片均完全成活，术后随访6个月～4年，效果满意。结论内踝上逆行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 effect of repair in skin and soft tissue defect around malleolus or Achilles tendon exposure or ealeaneus tendon exposure by superior regressive skin flap graft. Methods From 2000, superior regressive skin flaps had been applied to repair 27 eases with skin and soft tissue defect or Achilles tendon exposure around malleolus after trauma,tumor or other occasions. The maximal skin and soft tissue defect size was 6cm × 14cm,the maximal ealeaneus exposure size was 5cm × 10cm. Results A total of 26 eases obtained complete success with satisfactory results, 1 ease of necrosis delayed wound healed by latissimus dorsal myoeutaneous flap graft. Conclusion The superior regressive skin flap graft is an effective and convenient method to repair skin and soft tissue defect around malleolus or Achilles tendon exposure or ealeaneus tendon exposure.