内踝前动脉穿支蒂逆行筋膜皮瓣修复足背软组织缺损

Reverse fasciocutaneous flap pedicled with perforator branch of anterior medial malleolus artery for soft tissue defect on the dorsal side of foot

目的报道以内踝前动脉穿支为血管蒂的逆行筋膜皮瓣修复足背软组织缺损的临床效果。方法在多普勒血流探测仪引导下，设计以内踝前动脉穿支为血管蒂及旋转点，沿隐神经营养血管轴线切取皮瓣，逆向转位修复足背部皮肤缺损创面。结果2002年2月至2008年3月，于临床应用12例，皮瓣全部成活，皮瓣面积为13．5cm×3．0cm～8cm×3cm，穿支血管蒂位于内踝前下方0．5～1．5cm处。随访6-18个月，皮瓣质地良好，外形与功能恢复满意。结论该皮瓣设计灵活，切取方便，血供可靠，适于修复足背部的皮肤软组织缺损创面。

Objective To report the therapeutic effect of reverse fasciocutaneous flap pedicled with perforator branch of anterior medial maUeolus artery for soft tissue defect on the dorsal side of foot. Methods The perforator branch was located under the guidance of Doppler flowmeter. The flap was designed along the saphenous neurovascular axis. Then the flap was transferred reversely with the perforator branch as rotation point. Results From Feb.2002 to Mar.2008, 12 cases were treated and followed up for 6 - 18 months. All the flaps survived completely. The flap size ranged from 13.5 cm × 3.0 cm to 8 cm × 3 cm.The perforator branch located at 0. 5 - 1.5 cm anterior-inferior to the medial malleolus. Both the cosmetic and functional results were satisfactory. Conclusions The flap has a reliable blood supply and a flexible design. It is easily performed for soft tissue defect on the dorsal side of foot. It is a new type flap which combined neurocutaneous vascular flap with the perforator flap.