隐神经营养血管蒂逆行岛状皮瓣的临床应用

Clinical use of distally based saphenous neurovascular flap

目的探讨隐神经营养血管蒂岛状皮瓣临床应用的效果。方法以小腿隐神经营养血管为蒂设计并切取皮瓣,逆行转移修复小腿下段、踝部、足跟部、足背及足内侧皮肤缺损10例。结果10例皮瓣中除1例修复前足内侧皮瓣远端部分坏死外,余9例皮瓣全部成活。随访6个月～2年,皮瓣色泽、质地、弹性良好,无破溃发生。结论隐神经营养血管蒂岛状皮瓣具有血供可靠、操作简单、成活率高以及不牺牲重要血管等特点,是修复小腿下段、踝部、足跟部、足背及足内侧皮肤软组织缺损的理想方法之一,但该皮瓣切取后需牺牲大隐静脉和丧失隐神经支配区的皮肤感觉是其缺点。

Objective To investigate the clinical resuh of distally based saphenous nerve nutritional blood vessel is land flap. Methods 10 cases of soft tissue defects on the remote part of the leg,on the heel and near the ankle were treated with distally based island saphenous neurovascular flaps. Results All 10 flaps were survived completely except one with distant edge become necrosis. In the follow-up for six month to 2 years, all flaps had good color,texture and flexibility, and no ulcer was found in the flaps. Conclusions This flap has good blood supply and high success rate. The operation is less traumatic and easy to perform, and the chief vessel is undamaged. It is an ideal flap to repair the soft tissue defect of the lower leg,ankle, heel and the dorsum and medial of the foot. The disadvantage of this operation is numb of the medial foot and the saphenous vein is eut.