腓肠神经营养血管逆行岛状皮瓣治疗足踝部软组织缺损38例报告

Application of the reversed sural neurocutaneous island flap in repairing the soft tissue defect of the foot and ankle(report of 38 cases)

[目的]探讨腓肠神经营养血管逆行岛状皮瓣治疗足踝部软组织缺损的临床应用。[方法]1997年6月-2007年12月,采用腓肠神经营养血管皮瓣转移修复38例小腿中下段、踝关节周围及足跟等处软组织缺损,患者年龄7～65岁,平均38.3岁,病史最长11年,皮瓣面积最大17cm×12cm,最小5cm×4cm。[结果]33例皮瓣完全成活,5例皮瓣远端皮缘部分坏死,经过中药短期换药后均愈合。随访6个月～10年,疗效满意。[结论]腓肠神经营养血管皮瓣切取简单,血供可靠,不损伤主要知名血管,是修复足踝部软组织缺损较理想的方法。

[ Objective] To investigate the clinic application of the reversed sural neurocutaneous island flap in repairing the soft tissue defect of the foot and ankle. [ Method] From June 1997 to December 2007,38 cases of the lower leg, around the ankle and the heel soft tissue defects were treated with the reversed sural neurocutaneous island flap. The average of the patients was 38.3 years （ range 5 to 65 ）. The longest medical history was 11 years. The lagest area of flap was 17 cm × 12 cm and the smallest was 5 cm ×4 cm. [ Result] Thirty-three flaps were completely survived, there were 5 cases with distal edge of the flaps partially necrosis and healed after short time dressing change. The patients were followed up for half a year to 10 years and the curative effect was satisfactory. [ Conclusion] The reversed sural neurocutaneous flap is simple to harvest and its blood supply is reliable without the sacrifice of a major blood vessel. So it is an ideal method for repairing the soft tissue defect of the foot and ankle.