随意型皮筋皮瓣 修复下肢组织缺损55例报告

REPAIRING 55 CASES OF LOWER LIMBS TISSUE DEFECT USING RANDOM PATTERN FASCIA SKIN FLAP

目的：探讨下肢软组织缺损的修复术式。方法：采用随意型筋膜皮瓣修复下肢皮肤及软组织（骨髓炎）缺损55例。结果：Ⅰ期修复52例，Ⅱ期修复3例；Ⅰ期愈合54例，延期愈合1例。结论：此类皮瓣可随意切取，不必吻合血管神经干，血供丰富；成功率高，费用低；并发症少，远期效果好。与其他岛状皮瓣比较，有不牺牲主要血管的优点，适应于深部组织损伤及溃疡所致的组织缺损。并对筋股皮瓣的临床解剖学概念及手术适应证进行讨论。

To investigate operative styles repairing the tissue defect of lower limbs. Methods: 55 patients lower limbs skin and soft tissue defect were repaired with random pattern fascia skin flap. Result: 52 patients (necrotic osteitis) were repaired through one-stage and 3 were done two-stage. 54 Cases intentioned first and 1 delayed. Conclusion: This type of shin flap can be random got, without combining blood vessels and nerves, and rich in blood supply. It has a high rate of success, low cost. few complication and good long-term follow-up results. Compare with the islandshaped skin flap, this type wouldn't destroy main blood vessels, and it is applyed in deep tissue lesion and the defect caused by ulcer. We also discuss about the anatomy concept of fascia skin flap and operation indication.