顺行及逆行腓肠神经营养皮瓣的临床应用体会

Clinical study of sural neurovascular flap for repairing tissue defect proximally or distally

目的:探讨腓肠神经营养血管皮瓣转移修复足背、足跟、踝部、膝部甚至大腿中下段组织缺损的临床应用效果。方法:回顾我科临床应用带筋膜蒂的腓肠神经营养血管岛状皮瓣经验,逆行应用修复足背、足跟、足底及踝部软组织缺损,顺行应用修复膝部甚至大腿中下段软组织的缺损。同时观察皮瓣的可切取范围、血液供应及静脉回流情况、血管蒂长度及血管蒂隧道的处理方法。结果:临床应用12例,皮瓣最大面积16cm×10cm,最长血管蒂14cm,转移皮瓣全部成活。结论:腓肠神经营养血管皮瓣血液循环丰富,损伤小、成活率高,设计处理适当不失为修复下肢软组织缺损的理想选择。

Objective To explore the clinical application of sural neurovascular flap to be transfered to repair tissue defect around the heel,foot dorsum,knee and even for thigh distally. Methods By retrospective study on 12 sural neurovascular flaps,some experience that the blood supply and venous return of flap and the position of supply vessel from peroneal artery on externalmalleous was achieved about sural neurovascular fascial island flap scope. Results The flap was used on total 12 cases with a maximum size of 16cmx10cm and longest vessel pedicle 14cm.AII 12 skin flaps depending on this arterial supply survived in clinical practice. Conclusions The sural neurovascular flap has sufficient blood supply and high survival rate without vascular anastomosis and major artery injure of lower limb.So it is an ideal flap for repairing the tissue defect around the foot dorsum,heel,malleolus,sole and knee even for thigh.