应用腓肠神经营养血管皮瓣修复小腿中下段前内侧软组织缺损

Application of the distally sural nerve nutrition blood vessel flap for repairing the soft tissue defects in the distal of anterior tibia

目的:总结应用腓肠神经营养血管皮瓣修复小腿中下段前内侧皮肤软组织缺损的临床疗效。方法:应用腓肠神经营养血管皮瓣治疗小腿中下段前内侧皮肤软组织缺损27例,在术中进一步采用多普勒血流探测仪探测皮瓣蒂再次确定其旋转点及切取覆范围,选择旋转点以外踝上5～7 cm;在显微镜下腓肠神经近端与受区感觉神经吻合,小隐静脉与大隐静脉或局部静脉吻合。结果:术后皮瓣全部成活,随访2年以上,功能良好,外形满意。结论:腓肠神经近端与受区感觉神经吻合,制成感觉皮瓣,为小腿中下段提供良好的覆盖及感觉功能,采用吻合小隐静脉的腓肠神经营养血管皮瓣修复小腿中下段前内侧创面。

Objective： To summarize the clinical effects of distally sural nerve nutrition blood vessel flap for repairing the soft tissue defects in the distal of anterior leg. Methods： To application sural nerve nutrition blood vessel flap for repairing the soft tissue defects in the distal of anterior leg, in 27 cases, using doppler flow imaging survey meter in the operationg to decide the range of flap, Choose swivel above 5 - 7 em on the lateral malleolus, far part of the sural nerve and small saphenous vein were connected with the far part of the wound broken nerve and great saphenous vein or region vein in microscope. Result： The all flap was healthing and outline form gratification in our group. Conclusions： Far part of the sural nerve was connected with the far part of the wound broken nerve in microscope, to make the flap with sensation, application of sural nerve nutrition blood vessel flap to supply favourable overjut as well as sensory function for middle and inferior segment of leg.