超长腓肠神经营养血管皮瓣的临床应用

Clinical Application of Ultra Long Sural Nerve Nourishing Blood Vessels and Skin Flaps

目的：探讨延迟转移超长腓肠神经营养血管皮瓣的临床应用效果。方法对5例伴有肌腱、骨质等深部重要组织外露的创伤患者行超长腓肠神经营养血管皮瓣转移治疗，皮瓣切取前2周，在腘窝平面下小腿后侧上1／3做延迟倒“U”形切口，深达深筋膜深层，原位缝合，2周后常规切取皮瓣转移至患处，观察皮瓣成活情况及创面愈合效果。结果5例患者皮瓣全部成活；随访3个月～1年，5例患者的皮肤质地及外形均恢复较好。结论采用超长腓肠神经营养血管皮瓣延迟转移修复小腿上端及足踝部软组织缺损，增加了皮瓣长度，扩大了皮瓣修复范围，且切取简便，供血可靠，效果良好。

Objective Discuss the clinical application results of delayed transplant of the ultra long sural nerve nourishing blood vessels and skin flaps. Methods Such delayed transplant therapy was applied in 5 patients with exposed deep tissues of tendons and bones. Two weeks before cutting skin flaps, delayed inverted U-shaped notches were made in crus back upper 1/3 under popliteal fossa planar, reaching to deep fascia deep layer, and then were sutured in situ. The skin flaps were cut in the conventional way two weeks later and transplanted to the wound site. The survival rate of the flaps and the status of wound healing were observed. Results Transplanted flaps in 5 patients all survived and recovered good appearance and texture in follow-ups of three months to one year. Conclusion Application of delayed transplant of the ultra long sural nerve nourishing blood vessels and skin flaps to repair the soft tissue defect in the ankle and upper shank increases the length of skin flap, expands the area for repair, and features easy cut, reliable blood supply and good effect.