游离胫后动脉穿支皮瓣修复趾腓侧皮瓣供区创面

Free posterior tibial perforator flap for coverage of donor defect of the big toe after free lateral pulp flap transfer

目的介绍应用游离胫后动脉穿支皮瓣修复蹰趾腓侧皮瓣供区创面，为减少供区损伤提供治疗方法。方法2009年6月至2010年12月，对5例拇、手指软组织缺损，采用躅趾腓侧皮瓣游离移植修复，对躅趾供区创面同时采用游离胫后动脉穿支皮瓣进行移植修复，小腿供区创面直接缝合。结果术后5例游离蹰趾腓侧皮瓣和胫后动脉穿支皮瓣全部存活，皮瓣外观和功能恢复良好，平均随访时间7个月，躅趾腓侧皮瓣和胫后动脉穿支皮瓣两点分辨觉平均为5mm和7mm。结论游离躅趾腓侧皮瓣修复拇、手指软组织损伤的同时应用胫后动脉穿支皮瓣一期修复躅趾供区创面，避免了术后局部疼痛、皮肤破溃等并发症，是一种理想的覆盖供区创面的治疗方法。

Objective To explore the application of free posterior fibial artery perforator （PIP） flap for coverage of donor defect of the big toe after free lateral pulp flap transfer and decreasing donor site morbidity. Methods From June 2009 to December 2010, 5 cases of soft tissue defect of the thumb and fingers were treated by free transfer of the lateral pulp flap from the big toe. The resulting defects of the donor big toes were repaired by free PIP flap transplantation. Flap donor sites at the calf were directly closed. Results All flaps survived with desirable appearance and sensation, Mean follow-up time was 7 months. Two-point discrimination in the lateral pulp flaps transferred to the thumb and fingers and in the PIP flaps was 5 mm and 7 mm, respectively. Conduslon PIP flap transfer for coverage of donor big toe defect resulted from flee lateral pulp flap transfer is an ideal surgical procedure. It prevents donor site morbidities such as pain and ulceration.