腓肠神经营养血管岛状皮瓣的临床应用

Clinical Application of Sural Nerve Island Flap Pedicled with Collateral Vessels

目的 总结逆行腓肠神经营养血管岛状皮瓣的临床应用经验。方法 以腓肠神经及其营养血管为蒂的逆行岛状皮瓣修复胫前、踝部、足跟部软组织缺损创面 2 3例 ,皮瓣大小为 ( 3cm× 5cm)～( 8cm× 1 5cm)。结果 1 9例完全成活 ,3例出现水泡及边缘 0 .5cm左右皮肤坏死 ,经换药愈合 ,1例远侧部分皮肤坏死 ,移植游离皮片得以修复。 2 1例获随访 3～ 6个月 ,1 6例皮瓣恢复保护性感觉 ,另 5例感觉无恢复。无溃疡、瘘管、骨髓炎出现。结论 此皮瓣不损伤小腿重要血管及神经 ,血供可靠 ,解剖容易 ,是修复小腿中下部。

Objective: To sum up the experience of clinical application of distal base sural nerve island flap. Methods:The posterior island flaps of leg pedicled with sural nerve and its nutrient vessels were performed to repair the soft tissue defects of the anterior leg,ankle and heel in 23 cases.The range of flaps was 3 cm×5 cm to 8 cm×15 cm .Results:19 flaps survived perfectly , 3 cases were healed after changing dressing, and one flap necrosed partially was found and repaired by free skin transplantation.21 cases were followed up for 3 to 6 months,no ulcer,fistulation or osteomylitis was found.The sensation of the flap was recovered slightly in 16 cases. Conclusion:The flap does not damage critical blood vessels and nerves of the leg. It has more reliable blood supply and great rotation.It is easy to resect .It is an ideal flap for repairing the soft tissue defects in the anterior leg,ankle and heel.