逆行神经营养皮瓣部分坏死原因分析

Analysis of partly necrosis cause of retrograde neurovascular flap

目的分析逆行神经营养皮瓣部分坏死原因,总结经验并提出预防对策。方法对28例小腿、跟踝部软组织缺损伴深部组织外露创面给予相应的带蒂皮瓣转移等治疗。结果 28例患者手术均顺利,23例创面顺利一期愈合,3例皮瓣边缘部分坏死经换药后愈合,2例皮瓣远端1/3坏死,1例改用其他皮瓣修复,1例经长时间换药后逐渐愈合。结论小腿逆行神经营养皮瓣是修复小腿、跟踝部软组织缺损的可靠方法,但应用时注意皮瓣的适应证,严格按相关操作原则进行手术,尽可能减少并发症的发生。

Objective To investigate the part necrosis causation of retrograde neurovascular flap.Methods 28 patients with soft tissue defects at leg,heel and ankle were treated with transfered pedicled skin flap.Results All patients were operated successfully.The wound surface of 23 case was primary healing.The skin flap edge of 3 cases was partly necrosis,and treated by change dressings.The skin flap one third distal end of 2 cases was necrosis,1 case treated by transfer other pedicled skin flap,and another treated by long term change dressings.Conclusion The distally perforatorbased neurofaciocutaneous flaps is a reliable method for the soft tissue loss on leg,heel and ankle.In order to reduce the complication of flaps,we should pay attention to the indication and operate strictly abide by the correlated principle.