应用腓肠神经营养血管蒂逆行岛状皮瓣修复下肢复杂性软组织缺损的临床体会

Clinical application experiences of reserved island flap pedicled with nutrient vessels of sural nerve for the lower extremity complicated soft-tissue defects

目的探讨临床应用腓肠神经营养血管蒂逆行岛状皮瓣修复下肢复杂性软组织缺损的方法及临床应用体会。方法2007年～2010年对足踝部、跟部、胫前下1／3伴有骨、肌腱和钢板外露创面应用腓肠神经营养血管蒂逆行岛状皮瓣修复，术前常规行多普勒血流探测仪检查和下肢静脉造影，术中必要时将小隐静脉与浅静脉吻合。结果临床应用16例患者，其中14例应用该皮瓣修复，2例同时将小隐静脉与创面附近浅静脉吻合，皮瓣均一期愈合。结论腓肠神经营养血管逆行岛状皮瓣修复下肢复杂性软组织缺损创面手术简便，临床效果好。

Objective To investigate the methods and clinical application of lower extremity complicated soft - tissue defects with nutrient vessels of sural nerve. Methods Between 2007 and 2010, 16 patients with soft- tissue defects around ankle, calcaneal region, the lower third ofthe leg wounds with bone, muscle tendon and niekelclad exposure were reconstructed by use of reserved sural neuro vascular faseiocutaneous island flap, preoperative making the leg phlebography with doppler blood flow survey meter, intraoperative suturing the small saphenous vein and superficial vein introperative in time of necessity. Results All the flaps survived, two of them saturating the small saphenous vein and superficial vein around wounds. Conclusion The reserved island flap pedicled with nutrient vessels of sural nerve are suitable to repair most of the lower extremity com- plicated soft - tissue defects, and make the operations convenient and good clinical effect.