增加皮肤蒂的改良逆行腓肠神经营养血管皮瓣在跟腱外露中的应用

Modified Retrograde Sural Neurofasciocutaneous Flap by Extra Skin Flap Pedicle for Treating Exposure Tendo Calcaneus

目的:探讨提高逆行的腓肠神经营养血管皮瓣修复跟腱外露更为可靠的手术方法。方法:对10例跟腱外露的患者,应用改进后的增加皮肤蒂的逆行腓肠神经营养血管皮瓣进行修复,通过在已设计的皮瓣蒂部增加额外的皮肤蒂,使得皮瓣蒂部的容积增加,提高皮瓣的静脉回流效率,减轻皮瓣术后的静脉淤血程度,提高皮瓣的成活率,更好地覆盖外露的跟腱,或者为后期的跟腱重建提供良好的覆盖。结果:10例皮瓣均成活良好,无严重静脉淤血等情况出现,所覆盖的跟腱区域恢复良好。结论:应用增加皮肤蒂的改良逆行腓肠神经营养血管皮瓣,能明显减轻皮瓣中的静脉淤血程度,改善皮瓣血运,对跟腱外露的修复具有重要意义。

Objective This article is aimed at discussing how to increase the reliabilty of retrograde sural neurofasciocutaneous flap in treating tendo calcaneus exposure. Methods 10 cases of tendo calcaneus exposure are treated by modified retrograde sural neurofasciocutaneous flap. By adding an extra skin pedicle to the designed skin flap pedicle, the usable capacity of the latter will be enlarged to increase venous reflux and alleviate the venous congestion of the skin flap. With this method, the survival rate of the skin flap can be improved to better cover the exposed tendo calcaneus or effectively cover the tendo calcaneus in later reconstruction. Results In 10 cases, all the modified retrograde sural neurofasciocutaneous flaps are surviving well without severe venous congestive syndrome. And the area covered by the flap on tendo calcaneus has healed well. Conclusion By using modified retrograde sural neurofasciocutaneous flap with an extra skin pedicle added to it, the venous congestive can be obviously alleviated and the blood circulation can be improved. This method can be significant to the repair oftendo calcaneus exposure.