腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣的应用及静脉并发症的预防处理

Reverse sural neurovascular island flap for reconstruction of soft tissue loss on foot and prevention from venous related complications

目的探讨腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣修复足踝部创面的效果及静脉并发症的预防和处理。方法切取腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣时筋膜皮肤蒂保留3cm宽皮肤,其宽度尽量与皮瓣宽度一致;选择性在旋转轴点附近结扎小隐静脉远心端;明道转移;术后弹性绷带适当加压包扎。结果本组23例皮瓣全部成活,无严重静脉并发症发生。结论腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣是修复足踝部创面的理想术式,静脉并发症完全可预防或处理。

Objective To assess the effect of reverse sural neurovascular island flap in reconstructing soft tissue loss on foot and explore the effective measure for preventing from venous related complications.Methods The pedicle was reserved to be 3 cm in width,which was as same as the flap in design.Small saphenous vein was ligated around the flap rotation point.The flap was transferred through open tunnel.Then rubber bandage was utilized to achieve depression after operation.Results All neurovascular island flaps survived completely without any venous related complications.Conclusion The use of the reverse sural neurovascular island flap for repairing soft tissue defects of the foot is safe and reliable,and the venous related complications could be prevented and managed.