游离腓动脉穿支动脉皮瓣修复手足皮肤缺损

Free perforator flap from peroneal artery to repair hand and foot skin defects

目的探讨应用游离腓动脉穿支动脉动脉皮瓣修复手足软组织缺损的方法和临床效果。方法对32例手足皮肤缺损应用游离腓动脉肌皮穿支动脉动脉皮瓣修复。切取面积从5.0cm×4.5cm～12cm×9cm。其中28例以肌皮穿支动脉动脉为蒂,4例以肌间隔穿支动脉为蒂。动脉血管蒂与受区采用端侧吻合或端端吻合。结果术后皮瓣全部成活。1例术后发生动脉危象,经重新吻合后成活。随访6月～2年,皮瓣略臃肿,外观及弹性良好。结论腓动脉穿支动脉动脉皮瓣的血管解剖恒定、皮瓣厚薄适中,操作较腓动脉皮瓣简化,是修复手部及足背远端软组织中小面积缺损的有效方法。

Objective To explore the surgical technique and clinical outcome of applying the free flap nourished by musclecutaneous perforators of peroneal artery to repair skin defects of the hand and foot. Methods Totally 21 foot skin defects and 11 hand skin defects with the size from 5.0 cm × 4.5 cm to 12 cm × 9 cm were involved in the study. In most cases the musclecutaneous branch was chosen as the anastomose vessels. The blood vessels were anastomosed either end-to-end or end-to-side. Results All the transferred free flaps survived uneventfully except one artery crisis happened postoperatively. Followed up for 6 to 24 months, the outlooks as well as flexibility were satisfied. Conclusions The perforators of peroneal artery had a relatively invariable anatomy, easier to dissect than the peroneal flaps. Thus, it was useful to repair small and middle areas of skin defects in hand and foot.