腓肠神经营养血管皮瓣修复小腿足踝部缺损

Application of sural neurocutaneous flap to repair soft tissue defects of leg,ankle and foot

目的探讨带蒂腓肠神经营养血管皮瓣修复小腿及足踝部远端软组织缺损的疗效。方法应用带蒂腓肠神经营养血管皮瓣修复24例小腿及足踝部远端软组织缺损患者。缺损面积为5 cm×6 cm～12 cm×8 cm。结果3例皮瓣远端边缘部分坏死,经换药后愈合;21例皮瓣全部成活。其中4例术后皮瓣明显肿胀,2周后消退,皮瓣成活。24例均获随访,时间6个月～2年,足背外踝区早期感觉减退,6个月时21例皮瓣麻痹区缩小。皮瓣两点辨别觉>2 cm者17例,7例足跟边缘区部分溃疡,换药后瘢痕愈合。皮瓣色泽、质地、弹性良好。结论应用腓肠神经营养血管皮瓣修复小腿下段及足踝部缺损手术操作简单,皮瓣血供充足,疗效可靠。

Objective To explore the application of pedieled sural ueuroeutaneous flap to repair distal lower leg and ankle and foot soft tissue defect. Methods Pedicled sural neurocutaneous flaps were used to repair 24 cases of distal lower leg, foot and ankle soft tissue defects. Results 24 cases of defect area were of 5 × 6 cm - maximum 12 × 8 cm. 4 cases of got swelling and subsided after two weeks;3 cases got distal flap edge necrosis, and healed after dress changing. All cases were followed up for 6 months to 2 years. The dorsal lateral malleolus area feeling was receded, and six months after operation, the two points discriminate distances were 〉 2 cm in 17 cases. 7 cases got marginal heel ulcer, and healed after dress changing. Skin color, texture, elasticity were restored well. Conclusions Application of sural neurocutaneous flap to repair the lower leg and ankle segment defect surgery is simple. The flap blood supply is adequate, which provides reliable effect.