带腓肠神经营养血管蒂逆行岛状筋膜皮瓣的临床应用

Clinical application of reverse island fascia-skin flap pedicled with the sural nerve nutrient vessel

目的探讨应用腓肠神经血管逆行岛状皮瓣修复小腿下段及足踝处软组织缺损的方法。方法应用腓肠神经血管逆行岛状皮瓣分别修复小腿下段皮肤缺损23例,修复足踝处软组织缺损12例。切取皮瓣面积10cm×8cm～17cm×10cm。结果术后35例腓肠神经营养血管皮瓣全部成活,28例创面Ⅰ期愈合;7例创面感染,经再次植皮术后均痊愈。所有患者获随访3～18个月,肢体功能及外形均满意。结论腓肠神经营养血管逆行岛状皮瓣是修复小腿下段、足踝处软组织缺损较理想的方法。

Objective To explore the clinical application of reverse island fascia- skin flap pedicled with the sural nerve nutrient vessel in repairing soft tissue defects of the lower leg and the ankle. Methods Twenty - three cases with soft tissue defects of the lower leg and 12 cases with defects on the ankle were repaired by using the reverse island fascia - skin flap pedicled with the sural nerve nutrient vessel. The areas of these flaps ranged from 10 cm × 8 cm to 17 cm × 10 cm. Results All patients were followed for 3 - 18 months, and the flaps in all 35 cases survived completely. 28 cases healed up in the initial recovery period. In 7 cases wounds were infected but healed up gradually after re- dermatoplasty, After heating, the texture, appearance and function of the extremity were good. Conclusion Use of the reverse island fascia- skin flap pedicled with the sural nerve nutrient vessel is an effective method for the reconstruction of soft- tissue defects in the lower leg and ankle.