小腿皮神经皮瓣及其穿支皮瓣的临床应用

Clinical application of neurocutaneous flap and perforator flap the heel

目的观察小腿皮神经皮瓣及其穿支皮瓣修复小腿远端及足踝部软组织缺损的临床效果。方法应用皮神经皮瓣及其穿支皮瓣修修复小腿远端及足踝部软组织缺损,其中包括带隐神经营养血管蒂皮瓣11例、带隐神经胫后动脉穿支蒂皮瓣10例、腓肠神经营养血管蒂皮瓣18例、带腓肠神经的腓动脉穿支蒂皮瓣3例。结果42例皮瓣中完全成活37例,部分坏死5例,成活后的皮瓣远期随访质地一般比较柔软,带蒂皮瓣一般比较薄,相对容易恢复保护性感觉。结论小腿远端及足踝部创面修复的皮瓣种类日渐增多,可根据临床具体情况选择合适的皮瓣来达到较满意的修复效果。

Objective To observe the curative effect of defect soft tissue ired with neurecutaneous flap and perforator flap the heel. Methods Defect soft tiof the distal shank and foot ankle repassue of the distal shank and foot ankle was repaired by neurocutaneous flap and perforator flap, including 11 cases of saphenous nerve-great saphenous vein nutritional vessels, 10 cases of ovascularized saphenous nerve flap based branches of the posterior, tibial artery, 18 cases of sural neurovascular flaps,3 cases of vascularized sural nerve flap based branches of the peroneal artery. Results In the 42 cases of skin flaps, there were 37 completely alive cases,5 partly dead cases and one case with dissecting failure. Most of the living skin flaps were soft and thin and were relatively easy to recovery the protecting sensation. Conclusion The kinds of skin flaps repaired for the distal shank and foot ankle defect gradually increase and the suitable flaps can be chosen according to the clinic to get satisfactory repairing effect.