腓肠内侧动脉穿支带蒂岛状皮瓣临床应用分析

Analysis of Clinical Application of Medial Sural Artery Perforator Pedicled Island Flap

目的分析腓肠内侧动脉穿支带蒂岛状皮瓣修复小腿上2／3软组织缺损的临床应用效果。方法自2003年5月～2008年1月，应用腓肠内侧动脉穿支带蒂岛状皮瓣修复22例膝和小腿上2／3软组织缺损，年龄20～53岁，平均35岁。其中，膝关节周围8例，小腿上2／314例。供区均选用同侧小腿。结果2例术后发生表浅感染，经更换敷料逐渐愈合，皮瓣全部成活，取得了较满意的效果。没有发现明显的供区功能障碍。结论该皮瓣以腓肠内侧动脉的肌皮穿支为血供，具有血供丰富、血管解剖恒定、血管蒂长以及皮瓣较薄的优点，带蒂岛状移植适宜修复膝和小腿上2／3软组织缺损。

Objective To analysis the results of clinical application of the medial sural artery perforator pedicled island flap for the coverage of soft tissue defects around the knee joint or upper two third of lower leg. Methods From May 2003 to January 2008,22 patients（16 men, 6 women）with soft tissue defects around the knee joint or upper two third of lower leg underwent reconstruction with the medial sural artery perforator pedicled island flap. Of them, 8 case recipient site were located on around the knee joint region, 14 cases upper two third of lower leg. They ranged in age from 20 to 53 years （mean,35y）. The donor leg wa） ipsilateral in all cases. Results Two cases sustained superficial infection postoperation and the gradual wound healed by daily wound dressings. All the flaps had survived com- pletely without major complication and obtained satisfactory clinical results ,There was no remarkable donor site morbidity. Conclusion The medial sural artery perforator flap is nourished by the musculocutaneous perforater of the medial sural artery. The flaps seem to has highly vascularize,a constant vascular anatomy and a long vascular pedicle. The flap is thin and suitable for the coverage of soft tissue defects around the knee joint or upper two third of lower leg.