大面积腓肠神经营养血管皮瓣的临床应用

Clinical application of the bigger sural neurocutaneous vascular flap

目的探讨大面积腓肠神经营养血管皮瓣的临床应用特点和临床效果。方法应用大面积的逆行腓肠神经营养血管皮瓣修复小腿下段及足踝部软组织损伤26例,术中注意:①增加皮瓣的筋膜蒂的宽度,不小于4～5cm;②腓肠神经内、外侧的皮神经都保留在皮瓣内;③小隐静脉干包含在皮瓣内;④保证蒂部的宽松。结果 26例皮瓣中24例生长良好,2例皮瓣末端部分表皮坏死,经换药后愈合。术后随访3个月～4年,皮瓣质地良好,外观恢复满意。结论大面积的逆行腓肠神经营养血管皮瓣可靠,能满意地修复足跟、足底大部、足背、踝及小腿中下段胫前区软组织缺损。

Objective To explore the clinical practice effect of sural neuroccutaneous vascular flap.Methods Use extended sural neuroccutaneous vascular flap repair shank section and foot ankle soft tissue damage 26 cases.In attention ① increases the flap fascia peduncular width,the width was not smaller than 4-5cm;② All cutaneous nerve retains in flap;③ contains the saphenous vein in flap;④ ensures the peduncle looseness.Results 18 cases grow well of the 26 cases,some epidermises of an end of 2 flap were bad,heal after changing dressings.After a follow up to 3 months-4 years,the quality of the flaps were good,the appearance of the flap swere satisfactory.Conclusion Extended retrograde sural neurocutaneous vascular flap of blood supply are reliable after taking certain measure,can ideal repair the defects of soft tissue in the heel,the greater part of sole,ankle and the district before the poor shank.