腓肠神经营养血管皮瓣与小腿内外侧皮瓣修复足踝部创面对比研究

Clinical comparative study of sural neurovascular flap in ankle

目的比较足踝部创面修复术中使用腓肠神经营养血管皮瓣与小腿内外侧皮瓣的效果。方法足踝部创伤30例,缺损范围3 cm×6 cm～30 cm×15 cm,随机分为腓肠神经营养血管皮瓣修复组(A组)和小腿内外侧皮瓣修复组(B组),每组各15例,所有供区直接缝合或植皮封闭。结果患者均获随访,随访时间3～6个月,A组无并发症,皮瓣质地优良,外观功能满意,修复创面最大30 cm×15 cm,供区创面封闭好;B组5例远端1/3坏死,植皮后愈合,修复创面最大18 cm×10 cm3,例供区创面植皮成活差5,例修复足背创面的皮瓣张力大,瘢痕重。结论腓肠神经营养血管皮瓣修复足踝创面效果优于小腿内外侧皮瓣。

Objective To compare the clinical effect of sural neurovascular flap with the lateral or reverse medial flap to repair the skin defects of leg,ankle and foot.Methods Thirty patients were divided into two groups.The defect area was 3 cm×6 cm to 30 cm×15 cm.In 15 cases used sural neurovascular flap(group A) was used and in the other 15 cases lateral or reverse medial flap of leg(group B) was used.All patients received direct suturing or skin graft for closure.Results All patients were followed up for 3 to 6 months.Patients in group A had not any complications;the flap texture,appearance and function were satisfactory;the largest repair area was 30 cm×15 cm.In group B,5 cases had distal 1/3 necrosis and wound healing after skin grafting;the largest repair area was 18 cm×30 cm.3 cases' skin graft survival was poor,and 5 cases had high dorsal foot flap tension and scar.Conclusions In the foot and ankle wound repair operation,both the sural nerve nutrient artery island flap and the lateral or reverse medial flap of leg can be chosen.The sural nerve nutrient artery island flap has a better effect.