非恒定蒂胫后动脉链式穿支皮瓣的临床应用

Clinical application of posterior tibial artery chain perforator flap with unsteady pedicle

目的探讨应用胫后动脉穿支皮瓣修复小腿及足踝部皮肤软组织缺损的新方法。方法应用非恒定蒂胫后动脉链式穿支皮瓣修复小腿及足踝部皮肤软组织缺损32例,术前应用多普勒血流仪探测胫后动脉皮支位置,利用各皮支形成的链式供血方式,选择距创面直线距离最近的皮支点做为旋转点切取皮瓣修复创面。结果经1.5个月～2年的随访,所有皮瓣均成活良好,外观满意,无手术并发症。结论非恒定蒂胫后动脉链式穿支皮瓣不受蒂部位置的限制,切取灵活方便,符合以最小的供区代价换取最佳的修复效果的基本原则,是一种修复小腿及足踝部皮肤软组织缺损的理想术式。

Objective To investigate a new method of repairing skin and soft tissue defects of lower leg ankle and foot by using posterior tibial artery chain perforator flap.Methods Thirty two patients with soft-tissue defects of lower leg ankle and foot were treated with posterior tibial artery chain perforator flaps.The sites of posterior tibial artery branches were detected by using Doppler flowmeter before operation.Supplied by the chain form of terminal branches of the posterior tibial artery,the flap was designed carefully and the rotation point was at the recent branch to the wound.Results All patients were followed-up for 1.5 to 24 months,all the flaps were alive with good shape,and there were no complications in the donor site.Conclusion The posterior tibial artery chain perforator flap with unsteady pedicle has no restrictions of pedicle sites and could be cut flexibly,which meets with the rule of achieving the maximal efficacy at a minimal donor site ＂cost＂.So it is a perfect method to repair soft-tissue defect of lower leg ankle and foot.