腓肠神经营养血管肌皮瓣在修复小腿及足踝部软组织感染缺损中的应用

Application of myocutaneous flap of sural nerve nutrient vessel in reparing soft tissue defect and infection in shank and foot

目的探讨腓肠神经营养血管肌皮瓣逆行转位修复小腿下段及足踝部软组织感染缺损的应用。方法选取2006年6月至2011年6月32例小腿中下段及足踝部软组织缺损或骨缺损、骨髓炎患者,采用逆行腓肠神经营养血管肌皮瓣转移方法进行手术修复。结果 32例中29例皮瓣成活,3例皮瓣部分坏死,后经换药愈合。随访6～12个月,平均10个月,有3例皮瓣臃肿,行皮瓣修整,余皮瓣质地优良,外形满意,颜色接近正常,患者对皮瓣外形及治疗效果满意。供皮区植皮全部成活,外观满意。结论腓肠神经营养血管肌皮瓣是修复小腿及足踝部软组织缺损及感染的一种有效可行的方法。

Objective To evaluate the feasibility of neurovascular sural flap in treatment of osteomyelitis or infection at the shank,ankle and foot with soft tissue defects and bone defects.Methods Thirty-two cases of soft tissue defects and osteomyelitis of the lower leg and foot associated with or without bones defects were treated with neurovascular sural flap from June 2006 to June 2011.Results Of all the 32 flaps,29 flaps survived at the first intention.Partial necrosis in 3 flaps were cured at the second intention.All patients were followed up for 6 to 12 months（mean 10 months）.Corpulence in 3 flaps got good therapeutic effect after repair,the results showed that the appearance and function were satisfactory in all cases.Conclusion To repair soft tissue defect at the shank,foot and ankle with osteomyelitis,the neruovascular sural flap is a satisfactory method.