小腿毁损性损伤的皮瓣修复与重建

Repairing and reconstruction of microsurgical flap in leg serious defection

目的为解决小腿毁损性损伤的修复和重建。尽可能保留肢体。最大程度地恢复其功能。方法采用显微外科技术，应用巨大的联合皮瓣，吻合双套血管移植修复4例，另5例采用吻合对侧肢体血管桥接游离脐旁皮瓣修复。结果皮瓣全部成活，一期愈合，随访1个月～4年，下肢功能恢复良好，外形满意。结论巨大联合皮瓣是小腿毁损性损伤修复重建的良好方法，对侧肢体血管桥接可有效保障皮瓣血供。

Objective To explore and solve the repairing and reconstruction in leg serious damage. Methods Using microsurgical technique to reconstruct 9 cases leg serious defection,especially free combining flap with two area flap were applied in 4 cases, two set of vessel were anastomosised to repair the tremendous defection with deep tissue including in tendon, vessel, nerve injury and exposure. Another 5 cases were repaired with paraumbilical flap with opposite lateral vessel anastomosis. Results All 9 cases were applied successfully with 100% survived and were followed-up for one month to four years, all flaps were good and appearance was excellent, and there were satisfied function recovery. Conclusion It is better choice for repairing complex tissue defection in leg by combining giant free flap transplantation and it is also reliable method for flap circulation by opposite lateral vessel anastomosis.