腓肠神经营养血管皮瓣修复外伤性小腿及足部骨外露:15例临床报告

Sural nerve nutrient vessels of skin flap to repair the bone exposure in leg and foot wounds

目的总结应用腓肠神经营养血管皮瓣修复小腿及足部骨外露的临床效果及经验。方法回顾性分析2010年10月至2015年10月中国医科大学附属第一医院整形外科收治的15例外伤性小腿及足部股外露患者的临床资料。其中,胫骨外露10例,足跟骨外露5例;软组织缺损面积为6 cm×9 cm^9 cm×12 cm。所有缺损均采用腓肠神经营养血管皮瓣修复。结果本组14例皮瓣完全成活,1例局部坏死,最终瘢痕愈合。术后随访6~12个月,供受区愈合良好,无明显的功能障碍,临床效果满意。结论腓肠神经营养血管皮瓣血供丰富,手术设计灵活,同时皮瓣内带有感觉神经,保证了皮瓣感觉,是修复小腿及足部骨外露的有效方法。

Objective To explore the clinical curative effect of sural nerve nutrient vessels of the retrograde island flap to repair the bone exposure of leg and foot. Methods Between October 2010 to October 2015,15 patients with bone exposure of leg（ 10 cases） and foot（ 5 cases） were treated. Sural nerve nutrient vessels of the retrograde island flap was used to repair wounds with soft tissue defect in the area of 6 cm × 9 cm to 9 cm × 12 cm. Results Flaps got primary healing in 14 cases,second phase of healing in 1 cases. Patients had been followed up for 6-12 months,and the wounds healed well. There was the little influence of function,and patients could walk normally. Conclusion Sural nerve nutrient vessels of the retrograde island flap has reliable blood supply,surgery plans are flexible,and sensory function could be reserved at the same time. It is a good method to repair the bone exposure of leg and foot.