腓肠内侧动脉带蒂肌瓣的临床应用与改进

Clinical Application and Improvement of Medial Sural Artery Pedicled Muscle Flap

目的总结改进的腓肠内侧动脉带蒂肌瓣的临床应用结果。方法用此方法修复18例胫前区和膝关节周围软组织缺损。其中,胫骨上1/3软组织缺损6例,中1/3缺损5例,膝关节区7例。肌瓣表面行一期中厚网孔状游离植皮,供区直接缝合。结果肌瓣和其上植皮全部成活,受区外形较好,没有发现明显的供区功能障碍,取得了较满意的效果。2例术后发生表浅感染,经换药后愈合。结论该肌瓣以腓肠内侧动脉为血供,具有血供丰富、血管解剖恒定、血管蒂长以及肌瓣较薄等优点,带蒂移植适宜修复小腿上2/3和膝关节区软组织缺损。

Objective To summarize clinical application and improvement of the medial sural artery pedicled muscle flap to cover soft tissue defects on the lower leg and knee region. Methods Eighteen patients with soft tissue defects on the proximal two third of the lower leg and knee region underwent reconstruction with this method. Among them, recipient site were located on the upper one third of the lower leg in 6 cases, 5 cases were located on the middle one third of the lower leg and 7 cases on the knee region. The immediate coverage of the muscle flaps were performed by a meshed split-thickness skin graft. The donor site was closed directly. Results 2 cases sustained superficial infection post-operation and the wound obtained healing by daily wound dressings. All the muscle flaps and skin graft had survived completely without major complication with satisfactory clinical results. There was no remarkable donor site morbidity. Conclusion This muscle flap is nourished by the medial sural artery. The muscle flaps seem to has highly vascularity, a constant vascular anatomy and a long vascular pedicle. The muscle flap is thin and suitable for repair of soft tissue defect on the proximal two third of the lower leg and knee region.