腓肠神经营养血管筋膜皮瓣修复小腿足踝部缺损

Application of sural neurocutaneous flap to repair soft tissue defects of leg,ankle and foot

目的:探讨带蒂腓肠神经营养血管筋膜皮瓣修复小腿及足踝部远端软组织缺损的疗效。方法:应用带蒂腓肠神经营养血管皮瓣修复21例小腿及足踝部远端软组织缺损患者。缺损面积为5 cm×6cm^12 cm×8 cm。结果:18例皮瓣全部成活,其中3例皮瓣远端边缘部分坏死,经换药后愈合,4例术后明显肿胀,2周后消退。21例均获随访,时间0.5~2年,足背外踝区早期感觉减退,6个月时,18例皮瓣麻痹区缩小。皮瓣两点辨别觉>2 cm者16例,3例足跟边缘区部分溃疡,换药后瘢痕愈合。皮瓣色泽、质地、弹性良好。结论:应用腓肠神经营养血管皮瓣修复小腿下段及足踝部缺损手术操作简单,皮瓣血供充足,疗效可靠。

Objective： To explore the application of pedicled sural neurocutaneous flap to repair distal lower leg and ankle and foot soft tissue defects.Methods： Pedicled sural neurocutaneous flaps were used to repair 21 cases of distal lower leg,foot and ankle soft tissue defects and the defect areas were from 5 cm×6 cm to 12 cm×8 cm.Results： 18 cases of neurocutaneous flap all survived,3 cases got distal flap edge necrosis,and healed after changing dress.4 cases got obvious swelling and subsided after two weeks,All cases were followed up with regular visits for 6 months to 2 years.In the dorsal lateral malleolus area,feeling was receded at the first stage.18 cases＇ palaryzed areas were reduced six months after operation,the two points discrimination distances were more than 2cm in 16 cases,3 cases got marginal heel ulcer,and healed after dress changing.The skin color,texture and elasticity were restored well.Conclusion： Application of sural neurocutaneous flap to repair the lower leg and ankle soft tissue defect surgery is simple.The flap blood supply is adequate,which provides reliable effect.