内踝前穿支蒂隐神经营养血管皮瓣的临床应用

Clinical application of distally-based the perforator saphenous neuro-veno-fasciocutaneous flap

目的 报道内踝前穿支蒂隐神经营养血管皮瓣修复足踝部皮肤软组织缺损的临床效果.方法 在解剖学研究的基础上,采用内踝前动脉穿支蒂隐神经营养血管皮瓣10例,轴点在内踝尖上1～3 cm处,平均为2 cm,皮瓣切取的面积：4.0 cm×3.0 cm～8.0 cm×6.0 cm.结果 所有皮瓣均成活.术后有2例远端少部分皮肤坏死,但其皮下有肉芽组织生长,用中厚皮植皮愈合.所有病例均经1.5～6.0个月以上随访,患肢行走步态正常,有痛觉.结论 内踝前动脉穿支蒂隐神经营养血管皮瓣修复足踝部皮肤软组织缺损,近踝旋转点,转移可修复至中前足背,邻近转移,切取方便,血液供应可靠,是足踝部皮肤软组织缺损修复的良好供区.

Objective To explore distally-based the interal ankle perforator saphenou neuro-veno-fasciocutaneous flap has been universally adopted for the repairment of the foot and the ankle soft-tissue defects.Methods Lay a foundation of anatomic studying,using the interal ankle perforator saphenous neuro-venofasciocutaneous flap 10 cases, the flap axis point was 1-3 cm above the pink of the interal ankle, average 2 cm. The scope of the flap were 4.0 cm× 3.0 cm-8.0 cm× 6.0 cm. Results All the perforator saphenous neuro-veno-fasciocutaneous flap were lively. About all, 2 cases had the small distant part necrosis, 1 case accompanying with subcutaneous tissue heels after change dressings, another heels after skin grating. All case can walk as usual, the flap had wear-resisting and keenly feel. Conclusion Distally-based the interal ankle perforator saphenous neuro-veno-fasciocutaneous flap, near ankle, donner area exiting fine, utlizing scope large, skin nice, grating easy, no hurting important blood vessle, alive rate high, it is an good donner area in repairing the foot and the ankle soft-tissue defects.