腓肠神经营养血管皮瓣修复老年足跟部癌肿切除创面

Sural nerve nutrient vessel flap to repair heel tumor excision wound

目的：总结采用腓肠神经营养血管皮瓣移植修复老年足跟部皮肤癌肿切除后缺损创面的临床疗效。方法2007年6月—2012年7月，对15例老年足跟部皮肤癌切除后缺损创面采用腓肠神经营养血管皮瓣进行修复。结果15例皮瓣中，1例皮瓣边缘部分坏死，经换药愈合；1例皮瓣下积液，经换药、引流，加压包扎后愈合；其余13例皮瓣均一期愈合。随访6～24个月，平均12个月，修复后的足跟部外形及功能良好。根据章鸣等综合评价体系，优良率为82.6％。结论腓肠神经营养血管皮瓣色泽、质地良好，手术操作简单易行、安全可靠，可有效地修复老年足跟部皮肤癌切除后的缺损创面。

Objective To summarize the of clinical effects the sural neurovascular flap for repairing the defect after resection in elderly heel skin cancer. Methods Between June 2007 and July 2012, 15 cases of elderly skin cancer after resection of the heel were repaired with sural neurovascular flap. Results The group of 15 cases, 1 case had marginal necrosis partly, healed by dressing change; 1 case had effusion under the flap, healed by dressing, drainage and pressure dressing; the other 13 cases healed by first intention. All of the 15 patients were followed-up after operation, the followed-up period was from 6 to 24 months, 12 months on average, the heel has good appearance and function after repairing. The excellent and good rate was 82.6% according to comprehensive evaluation system of Zhang Ming etc. Conclusion Sural neurocutaneous vascular flap has good color and texture, the operation is simple, safe and reliable, it can repair the defects after resection of heel skin cancer in elderly patients effectively. This method suits both high-end and low level hospitals, and deserves popularization.