不同旋转点腓肠神经营养血管皮瓣修复足跟部软组织缺损的临床效果

Clinical outcomes of sural neurovascular flap with different rotating points in repairing soft tissue defects of the heel

目的探讨不同旋转点的腓肠神经营养血管远端蒂皮瓣修复足跟部软组织缺损的效果。方法足跟部软组织缺损患者43例：16例（A组）采用低旋转点皮瓣,轴点在外踝尖上1~3 cm处;27例（B组）采用轴点在外踝尖上5~7 cm。术后5 d,评估两组皮瓣成活及并发症情况。结果 A组皮瓣完全坏死1例,部分坏死2例,有水泡或淤血3例;B组皮瓣完全坏死1例,部分坏死3例,有水泡或淤血4例。两组疗效相仿（P〉0.05）。结论两种旋转点的腓肠神经营养血管远端蒂皮瓣修复足跟部软组织缺损的临床效果相仿。

Objective To compare the clinical outcomes of sural neurovascular flap with different rotating points in repairing soft tissue defects of the heel.Methods Of 43 patients with soft tissue defects of the heel,16 cases（group A） were treated with lower rotating point sural neurovascular flap（flap axis point was at 1-3 cm above the pink of the external heel） and 27 cases（group B） with higher rotating point sural neurovascular flap（flap axis point was at 5-7 cm above the pink of the external heel）.The clinical outcomes were evaluated and compared 5 days after surgery.Results Group A had 1 case with complete necrosis of the flap,2 cases with partial necrosis of the flap and 3 cases with tension blisters or the risk of venous congestion,which in group B were 1 case,3 cases and 4 cases,respestively.The clinical outcomes of two groups were similar.Conclusion The clinical outcomes of sural neurovascular flap with lower and higher rotating points are similar in repairing soft tissue defects of the heel.