带胫前动脉穿支的腓动脉穿支皮瓣修复前中足背创面

Peroneal artery perforator flap with anterior tibial artery perforator in repair of the wound of dorsum of forefoot and midfoot

目的探讨携带胫前动脉穿支的腓动脉穿支皮瓣修复前中足背软组织缺损的临床疗效。方法2015年2月至2019年7月,以携带胫前动脉穿支的腓动脉穿支皮瓣修复足背软组织缺损患者42例,其中男25例,女17例,年龄44~73岁,平均62岁。软组织缺损面积7 cm×4 cm^18 cm×5 cm。手术使用胫前动脉穿支联合腓动脉穿支供血的小腿前外侧岛状皮瓣逆行转移修复,供区以全厚皮片植皮。术后采用门诊结合微信随访,观察记录皮瓣外观及肢体恢复情况。结果42例皮瓣均顺利成活,供区植皮均一期成活。术后随访3~12个月,末次随访皮瓣外形美观,质地柔软,足外观和功能恢复良好。结论以胫前动脉穿支联合腓动脉穿支供血的双血供岛状皮瓣血供可靠,修复范围大,可修复距离远,修复前中足背组织缺损可获得良好的效果。

Objective To investigate the clinical effectiveness of peroneal artery perforator flap with anterior tibial artery perforator in repair of the soft tissue defect of dorsum of forefoot and midfoot.Methods From February,2015 to July,2019,peroneal artery perforator flaps with anterior tibial artery perforator were used to repair dorsal foot soft tissue defect in 42 patients.There were 25 males and 17 females,with an averge age of 62(44-73)years.The size of soft tissue defect ranged from 7 cm×4 cm to 18 cm×5 cm.The recipient sites on forefoot and midfoot were repaired by peroneal artery perforator flaps with anterior tibial artery from the anterolateral aspect of shank.The donor sites were resurfaced with full-thickness skin graft.All patients were followed-up at the outpatient clinic or through WeChat for 3-12 months.The appearance of the flaps and limb recovery were recorded.Results All flaps survived successfully.The donor sites and recipient sites were well healed.At the last follow-up,the texture and aesthetic of flaps were good,and the appearance and function of the foot were satisfactory.Conclusion The peroneal artery perforator flaps with anterior tibial artery double blood supply and can be designed to repair large and distanced soft tissue defect of forefoot and midfoot.