逆行腓动脉穿支蒂腓浅神经营养血管皮瓣修复足踝软组织缺损

Reversed Peroneal Perforator Superficial Sural Nerve Nutrient Vessel Flap Pedicled with Peroneal Vessel for Reconstruction of Soft Tissue Defect in Ankle and Foot

目的评价逆行腓动脉穿支蒂腓浅神经营养血管皮瓣修复足踝软组织缺损的临床效果。方法对25例足踝部软组织缺损的患者采用逆行腓动脉穿支蒂腓浅神经营养血管皮瓣进行修复。其中,以腓动脉终末穿支的升支为蒂19例,以其降支为蒂6例。软组织缺损大小10cm×9cm～4cm×3cm,皮瓣面积11cm×9.5cm～6cm×5cm。结果 23例皮瓣完全存活,另2例皮瓣远端部分坏死,经换药后植皮修复。皮瓣术后轻度肿胀,无瘀血。术后随访6～18个月,皮瓣质地优良,蒂部无臃肿。结论以腓动脉穿支为蒂的腓浅神经营养血管皮瓣血供可靠、质地优良,是修复足、踝软组织缺损的良好选择。

Objective To explore the clinical effect of reversed peroneal perforator superficial sural nerve nutrient vessel flap pedicled with peroneal vessel for reconstruction of soft tissue defects in ankle and foot.Methods Twenty five patients with soft tissue defects in ankle and foot were treated by superficial sural nerve nutrient vessel flap.Nineteen flaps were supplied by the ascending branch of the terminal peroneal perforator,while 6 flaps were supplied by the descending branch of the terminal peroneal perforator.The area of tissue loss ranged from 4 cm × 3 cm and 10 cm × 9 cm,and the flaps were measured from 6 cm × 5 cm and 11 cm × 9.5 cm in size.Results Twenty three flaps survived completely,while 2 flaps occurred necrosis distally which were treated by debridement and skin graft coverage.Mild swelling was observed in the early postoperative days,without severe venous congestion.The follow-up ranged from 6 to 18 months,and the cosmetic and plastic aspects of the flaps were evaluated as acceptable in all cases.The donor site healed uneventfully.Conclusion The reversed superficial sural nerve nutrient vessel pedicled with flap peroneal perforator provides a reliable tool for repairing soft-tissue defects of ankle and foot.