穿支蒂螺旋桨皮瓣修复足踝部软组织缺损25例临床分析

Application of perforator pedicled propeller flaps for soft-tissue coverage of the lower leg and foot de- fects：25 cases report

目的探讨穿支蒂螺旋桨皮瓣在足踝部软组织缺损创面修复中的应用效果。方法自2007年7月到2011年12月，对足踝部软组织缺损患者采用穿支蒂螺旋桨皮瓣修复25例，穿支动脉来源分别为腓动脉18例，胫后动脉6例，足背动脉1例。皮瓣面积4cm×10cm～9cm×33cm。结果供区直接缝合9例，游离植皮16例，有3例皮瓣术后出现静脉淤血，2例经滴血疗法最终皮瓣成活，1例皮瓣远端1／3坏死，经清创后游离植皮治愈。所有患者均获随访，随访时间1～26个月，所有皮瓣蒂部平整，外表美观，患者较为满意。结论穿支螺旋桨皮瓣操作简单、安全有效，在足踝部软组织缺损创面的修复中比其他带蒂皮瓣更具优越性。

Objective To investigate the clinical efficiency of perforator pedicled propeller flaps for soft-tissue coverage of the lower leg and foot defects. Methods From July 2007 to December 2011, twenty- five cases with soft-tissue defects of the lower leg and foot were cured by using the perforator propeller flaps. The origins of the perforator were 18 cases from peroneal artery, six cases from posterior tibial artery and 1 case from dorsal foot artery. The minimum of the flap scale was 4-9 cm, and the maximum was 10-33 em. Results All cases were followed-up from 1 to 26 months. All the flap pedicles were smooth with a satisfied appearance. The donor sites were sutured directly in 9 cases and cured with skin-grafting in 16 cases. Three cases suffered from vein congestion, two cases were cured by incisions in the distal parts of the flaps, one flap had necrosis of the distal 1/3 part and was cured by skin-grafting. Conclusion The perforator pedi- cled propeller flap is a simple, safe and useful flap. It has more advantages than other pedicled flaps for soft- tissue coverage of the lower leg and foot defects.