腹壁下血管腹直肌瓣移植加游离植皮修复足部及小腿软组织缺损

Repairing of leg and foot defects using free rectus abdominis muscle flaps pedicled with inferior epigastric vessels and skingrafting

目的:探讨应用游离腹壁下动脉肌瓣加中厚游离植皮修复小腿和足部软组织缺损的方法和疗效。方法:2001年5月～2006年1月,采用一侧腹壁下动脉肌瓣游离移植加中厚植皮修复足部软组织缺损伴有骨、肌腱外露及骨髓炎患者,部位分别为:小腿4例、足踝、足背、足跟部8例。结果:术后12例移植肌瓣及植皮区全部成活,术后随访6个月～1年,外形及功能良好。结论:游离腹壁下动脉肌瓣加中厚游离植皮修复小腿与足踝部软组织缺损具有血供丰富、抗感染力强和顺应性好,术后外形美观等优点,是修复下肢软组织缺损,尤其是并伴感染创面的理想方法。

Objective： To study the method and effects of free rectus abdominis muscle flaps and intermediate split thickness skin graft on repairing defects of/egs and foots, Methods： From May 2001 to January 2006, 12 cases of leg （4 cases） and foot defects （8 cases） were repaired using unilateral flee rectus abdominis flap and skin graft, For all cases, soft tissue defects were accompanied with osteomyelitis or the exposure of bone or tendon. Results： All patients were followed up 6 months to l year after operation. Rectus abdominis flaps survived well with good appearances and functions. Conclusions： Free rectus abdominis flap is a proper option for repairing soft tissue defects or irregular wounds on legs and foots. It has the advantages of abundant blood supply, strong anti-infection ability, good compliance and satisfied appearance. It is an ideal method to repair soft tissue defects of leg and foot.