吻合足背血管组织瓣移植的临床应用研究

Clinical Application Research in Transplantation of Free Tissue Flap of Dorsal Vascular Anastomosis of Foot

目的研究应用吻合足背血管进行游离组织瓣移植的临床应用价值。方法自2007年7月～2009年1月,对35例足踝及小腿部组织缺损病例行吻合足背血管的游离组织瓣移植修复,并对其行临床总结。其中男25例,女10例;年龄15～50岁,平均35.5岁。其中端侧吻合8例,端端吻合27例;足背血管游离平面在踝关节平面以下26例,在小腿下端9例,血管游离平面最高不超过小腿中下1/3。临床应用髂骨皮瓣8例,股前外侧皮瓣27例;创面位于足部18例,踝关节平面7例,小腿中下段5例,中上段5例。结果组织瓣移植全部成活,成活率达100%。其中1例发生血管危象,重新吻合血管后成活。足远端无血供障碍,未发生小腿前群肌缺血坏死表现。结论应用吻合足背血管进行游离组织瓣移植是修复足踝及小腿部组织缺损的理想方法。

Objective To investigate the clinical application value in transplantation of the free tissue flap of dorsal vascular anastomosis of foot. Methods The free tissue flap of dorsal vascular anastomosis of foot in a total of 35 patients with ankle and leg tissue defects was transplanted from Jul.2007 to Jan.2009. The clinical applicatlon was summarized. Among the total cases, 25 patients were male, 10 female. The age ranged from 15 to 50 years old, and the average age was 35.5 years old.Eight patients underwent end-side anastomosis, and 27 end-end anastomosis. The dissociation plane of the dorsal vessel of foot of 26 cases located below the ankle joint. Anastomotic plane of 9 cases laid in the distal leg. The highest vascular dissociation plane didn＇t locate above the distal 1/3 of the leg. Illiac flaps were used in 8 cases, the anterolateral femoral skin flap in 27 cases. The wound surface of 18 cases located in foot, 7 cases in ankle, 5 cases in the middle and superior segment of the leg, 5 cases in the middle and inferior segment of the leg. Results All of the 35 tissue flaps survived,the survival rate was 100%. Postoperatively, only 1 flaps encountered vascular complication, which survived completely with successful vessel exploration and anastomosis.The distal end blood supply disturbance didn＇t take place. The pregroup leg muscles ischemia and necrosis didn＇ t happen. Conclusion The application of the free tissue flap transplantation of dorsal vascular anastomosis of foot is a good way to repair the ankle and leg tissue defects.