踝足部皮肤软组织缺损的修复

The surgical treatment of the soft tissue defects in ankle and foot

目的总结用带蒂筋膜皮瓣、肌皮瓣修复踝部和足部皮肤软组织缺损的方法。方法41例年龄在4～58岁的足踝部皮肤软组织缺损的患者，选择适当的时机，采用9种带蒂筋膜皮瓣、肌皮瓣转移修复治疗。结果36例术后全部成活，创面一期愈合，2例皮瓣皮肤浅层坏死，3例皮瓣边缘少许坏死，换药后愈合。所有病例得到3～36个月随访，皮瓣良好。结论择机选用合理的带蒂皮瓣、肌皮瓣转移修复踝足部皮肤软组织缺损，可取得满意的疗效；其中腓肠神经营养血管蒂皮瓣是较理想的首选皮瓣。

Objective To discuss the surgical treatment of the ankle and the foot soft tissue defects. Methods 41 cases of the ankle and the foot soft tissue defects were treated with different types of pedicle flaps transfer 9 types of flaps were used in all patients. Results 36 flaps of 41 cases were completely survived, 2 case with superficial necrosis and 3 cases with distal edge partially necrosis and these 5 cases all healed by dressing change. All the cases were followed up 3 to 36 months（averaged 12 months）. The flaps completely survived. Conclusion The study showed that the soft tissue defects in ankle and foot can be constructed satisfactory by selecting a reasonable pedicle flap, especially the sural neurocutaneous island flaps.