延迟腓肠穿支带蒂皮瓣修复膝部软组织缺损

Delayed the medial sural artery perforator pedicled flap to repair soft- tissue defect of the knee

目的报告延迟腓肠内侧动脉穿支带蒂皮瓣修复膝部软组织缺损的临床应用结果。方法自2010年1月~2014年1月,应用延迟腓肠内侧动脉穿支带蒂皮瓣修复膝部软组织缺损6例(男5,女1)。患者年龄18~46岁,平均36岁。软组织缺损范围8.5cm×7.5cm^9cm×8cm。皮瓣切取范围9.5cm×9cm^10cm×9cm。皮瓣延迟时间:8~13天,平均11天。延迟期间创面暂时应用VSD覆盖。结果 1例皮瓣发生小的皮缘裂开,术后2周自然愈合,延迟皮瓣全部成活。术后随访2~4.5年(平均3.5年),受区与供区外形较好。膝关节功能用Baily提出的膝关节评分标准评定其疗效,良5例,可1例。本组取得了较满意的临床效果。结论该技术安全、可靠,适用于皮瓣切取较大或高风险患者。

Objective To report clinical application results of the delayed the medial sural artery perforator pedicled flap to repair soft-tissue defect of the knee. Methods From Jan 2010 to Jan 2014,6 patients （5 men, 1 woman） with soft- tissue defect in the knee underwent reconstruction with a delayed the medial sural artery perforator pedicled flap. They ranged in age from 18 to 46 years （mean, 36y）. Of them, 5 cases recipient site were located on the knee and one case on the upper 1/3 of the tibia. Soft-tissue defect ranged from 8.5cm× 7.5cm to 9cm×8 cm. Elevation of the flaps ranged from 9.5cm× 9cm to 10cm× 9cm. The delay period ranged from 8 to 13 days （mean, 1 ld）. Temporary wound coverage was achieved by VSD during the delay period. Results One patient developed small wound dehiscence, which spontaneous healed at two weeks after surgery. All the delayed flaps had survived completely. Follow-up period ranged form 2 to 4.5 years （mean, 3.5y） postoperatively. A good contour was confirmed at the recipient and donor sites. The function of the knee joints were evaluated with Baily scores. Good results were obtained in 5 eases and fair in 1 case. Satisfactory clinical results were obtained in this series. Conclusion This technique is safe, reliable, and particularly suitable for larger flap or high-risk patients.