胫后动脉穿支皮瓣修复足底负重区缺损

Posterior tibial artery perforator flap for reconstruction of defect of plantar weight-bearing area

目的 探讨胫后动脉穿支皮瓣修复足底负重区缺损的疗效.方法 2012年4月—2014年8月,采用胫后动脉穿支皮瓣逆行转移修复足底负重区缺损21例. 结果 术后21例皮瓣全部成活,1例皮瓣远端有约2.0 cm×2.5 cm的坏死,换药3周后皮片植皮愈合,15例获随访5-24个月. 皮瓣色泽、质地、外形良好. 结论 该皮瓣血运可靠,修复范围较大,不牺牲主要血管,手术简便安全,是修复足底负重区创面的理想皮瓣.

Objective To explore the clinical effect of posterior tibial artery perforator flap for reconstruction of defect at plantar weight-bearing area. Methods From April 2012 to August 2014, 21 patients with defect of plantar weight-bearing area were repaired by using the transfer of reversed of posterior tibial artery perforator flap. The donor sites was covered by free full-thickness flap, and the survival situation was assessed after surgery. Postoperative were followed up for a period of 5-24 months. Results All 21 flaps survived completely after surgery, 1 case happened distally flap necrosis which the size of flap necrosis was 2.0 cm ×2.5 cm. The skin graft healed after dressing change three weeks.15 case were followed up for a period of 5-24 months. The perforator flap was satisfactory in color, texture, appearance. Conclusion The posterior tibial artery perforator flap has a reliable blood supply and large range of repair without sacrificing main vessels. Operation performance is simple and safe. This kind of flap is really an ideal method for repair of wound surface at plantar weight-bearing area.