游离腓动脉远端穿支腓肠神经营养血管皮瓣修复上肢皮肤缺损

Transfer of free sural neurovascular flap based on perforating branches of the peroneal artery to repair soft tissue defects of the upper limbs

目的介绍游离腓动脉远端穿支腓肠神经营养血管皮瓣修复上肢皮肤缺损的手术方法。方法2006年6月-2007年8月，应用游离腓动脉远端穿支腓肠神经营养血管筋膜蒂皮瓣修复上肢皮肤缺损6例，其中缝合皮神经4例。结果术后6例皮瓣全部存活。随访时间为4个月至1．5年。皮瓣与供区皮肤外观基本一致，厚薄适中，弹性、质地好，外观满意；4例缝合皮神经的皮瓣感觉恢复至S2以上，余2例皮瓣恢复保护性感觉。结论游离腓动脉远端穿支腓肠神经营养血管皮瓣是修复上肢软组织缺损的有效方法。

Objective To introduce the surgical techniques of transferring sural neurovascular flap based on peroneal artery distal perforators for coverage of soft tissue defects of the upper limbs. Methods From June 2006 to August 2007, sural neurovascular flap based on peroneal artery distal perforators was transferred to repair upper limb soft tissue defects in 6 cases. In 4 cases cutaneous nerve of the recipient site was sutured to the sural nerve. Results All flaps survived completely. The patients were followed-up for 4 months to 1.5 years. The appearance and quality of the flaps, including eolor, thickness, texture and contour, are comparable with the recipient site. The flaps with cutaneous nerve coaptation recovered S2 and better sensation. The 2 cases without cutaneous nerve repair recovered protective sensation. Conclusion Free sural neurovaseular flap based on perforating branches of the peroneal artery is an effective method for treatment of soft tissue defect in upper limbs.