膝降动脉穿支皮瓣的临床应用

Clinical application of descending genicular artery perforator flap

目的 探讨膝降动脉穿支皮瓣的临床应用效果.方法 根据膝降动脉的走行、分支与吻合的解剖学特点,以缝匠肌前缘为中轴,股内侧肌、大收肌腱与股骨内侧髁所围成的三角形凹陷内的皮支穿出点为旋转点,在膝关节内侧上部设计膝降动脉穿支皮瓣,移位修复小腿上1/3前内面、膝关节前内面及胭窝皮肤软组织缺损.结果 临床应用共5例,皮瓣均成活,创面Ⅰ期愈合.经1～12个月随访,皮瓣质地优良、色泽接近正常,外形美观.结论 膝降动脉穿支皮瓣解剖位置恒定、血液供应良好、手术方法简单,是修复膝关节周围皮肤软组织缺损的可行方法之一.

Objective To discuss clinical application of descending genicular artery perforator flap.Methods According to the anatomic features of direction,branches and anastomosis of the descending genicular artery,the descending genicular genicular artery perforator flap at medial superior aspect of knee joint was designed to reconstruct the soft tissue defects at the anterior medial 1/3 of the calf and the anterior medial part and popliteal fossa of the knee,with the axis based on the anterior border of the Sartorius and with the pivot point on the site where the cutaneous branches from the superior medial genicular artery pierced out within the triangle concave surface bounded by the vastus medialis,the tendon of adductor magnus and the condylus medialis.Results All flaps survived well in five patients,with primary healing.After a follow-up of 1-12 months,all flaps turned out to be with good texture,near-normal color and good appearance.Conclusion With a constant anatomic location,excellent blood supply and easy surgical procedure,the descending genicular artery perforator flap is one of feasible ways for repair of soft tissue defects around the knee.