足部复合组织移植后供区的处理

Management of donor sites after transplantation of the foot composite tissues

目的探讨址部复合组织移植后供区的修复办法，以最人限度地减少足部供区的并发症。方法对2003年9门至2012年6月收治的59例足部复合组织移植术后留仃创面患者的临床资料进行回顾忡研究，男41例，女18例；年龄9～57岁，平均34．6岁。采用皮瓣转位或移植等方法进行创情覆盖修复，其中腓肠神经营养廊管皮瓣逆行转位修复22例，隐神经营养血管皮瓣逆行转位修复13例，外踝上皮瓣修复12例，第2跖背皮瓣修复9例，腹股沟皮瓣游离移植修复3例。结果足部供区遗留创嘶移植皮瓣伞部成活。所有患者术后随访6～24个月，平均12个月。供区移植皮瓣色泽币常，质地良好，无瘢痕、疼痛及溃破等情况发生。结论晕视足部复合组织移植术后供区的处理，精细修复前足横弓及韧带组织，应用皮神经营养血管皮瓣、邻近带蒂皮瓣转位或游离皮瓣移植等方法覆盖供区创面，可减少或避免供区并发症的发生。

Objective To explore tile method of repairing tt）e donor sites at tl^e foot after composite tissue transplantation. Methods From Seplember 2003 through June 2012, We repaired 59 eases of donor site defe, ets al Ihe foot with flap transposition or transplantation. They were 41 men and 18 women, aged from 9 to 57 years （average, 34. 6 years）. Of them, 22 were repaired by rein）grade lransposition of the sural neurovascular flap, 13 by retrograde transposition of the saphenous neurovascular flap, 12 by transplantation of lateral supramalleular flap, 9 by transplantation of the second dorsal metatarsal flap and 3 by free transplan- tatinn of groin flap. Results The flaps at the donor site all survived perfectly. The patients were fl^llowed up fi）r 6 tu 24 mnnlhs （average, 12 months） . The donor site flaps obtained normal color and good texture. will） no scar, pain or ulceration. Conclusions After composite tissue transplantation al the foot, we shouht attach special attention lu the repair of front foot transverse areh and ligament tissue. Transplantation or transposition of neuroeutaneous vaseular flaps, pedieled flaps or free flaps can well repair the donor site detkcts at the foot.