小腿皮神经营养血管逆行岛状皮瓣修复踝周创面

Reconstruction of the Soft Tissue Defects on Ankle with Retrograde Island Vascular Pedicle Skin Flap of Lower Leg Cutaneous Nerve Nutrient Vessel

目的探讨小腿皮神经营养血管逆行岛状皮瓣修复踝周创面的方法。方法2006年3月至2008年2月,对13例踝周皮肤软组织缺损创面应用小腿皮神经营养血管逆行岛状皮瓣进行修复,其中隐神经营养血管逆行岛状皮瓣3例,腓肠神经营养血管逆行岛状皮瓣10例。皮瓣切取面积为5.0cm×6.0cm～10.5cm×8.0cm。结果术后13例皮瓣,11例全部成活;1例远端部分坏死,经换药后痊愈;1例大部分坏死,患者拒绝再手术。随访5～15个月,皮瓣质地柔软、弹性好,外形满意,颜色接近正常,踝关节活动正常,患者对皮瓣外形及功能满意。供区植皮全部成活,外形满意。结论小腿皮神经营养血管逆行岛状皮瓣是修复踝周皮肤软组织缺损创面的一种理想手术方法。

Objective To observe the clinical effect of the transplantation of retrograde island vascular pedicle skin flaps of lower leg cutaneous nerve nutrient vessel for the repaire of the skin and soft tissue defects on ankle. Methods From March 2006 to February 2008,13 cases with skin and soft tissue defects on ankle were reconstructed with retrograde island vascular pedicle skin flaps of lower leg cutaneous nerve nutrient vessel. Among of these, 3 cases were repaired with the flaps of saphenous nerve nutrient vessel, 10 cases were sural nerve nutrient vessel,the size of the skin flaps were 5.0 cm × 6.0 cm- 10.5 cm × 8.0 cm. Results The flaps survived completely after operation in 11 cases,one flap were marginal necrosis,rerovered after change dressings,one necrosis largely,but no operated again. Followed up from 5 months to 15months ,all flaps survived ,the appearances ,extures and functions of the transplanted flaps were approached to normal skin,the functions of the ankles were good. Conclusion The transplantation of retrograde island vascular pedicle skin flaps of lower leg cutaneous nerve nutrient vessel is an effective method to repair the skin and soft tissue defects on ankle.