足内侧穿支皮瓣逆行转移修复前足软组织缺损

Retrograde transfer of medial foot perforator flap to repair forefoot soft tissue defects

[目的]介绍足内侧穿支皮瓣逆行转移修复前足软组织缺损的手术技术和初步临床效果。[方法]对14例前足软组织缺损患者行足内侧穿支皮瓣逆行转移修复治疗。于足内侧切取皮瓣,在第1跖趾关节内侧跖骨颈处显露皮穿支,于深筋膜下分离,仅保留供血的血管蒂与皮瓣相连,逆向旋转皮瓣,覆盖前足软组织缺损创面。[结果]14例患者皮瓣全部成活,皮瓣供区创面植皮成活良好。随访时间9个月~3年,成活皮瓣质地柔软,无明显的臃肿,均未行皮瓣修整,外观比较满意,穿鞋无明显的影响。[结论]前足软组织缺损运用足内侧穿支皮瓣逆行转移修复,手术操作安全可靠,对足部供区创伤较小,术后患足外观及功能均令人满意。

[Objective] To introduce the surgical technique and preliminary clinical results of retrograde transfer of medial foot perforator flap to repair the defects of forefoot soft tissue.[Methods] Fourteen patients with the defects of forefoot soft tissue were treated with the retrograde transfer of medial foot perforator flap.The flap was cut from the medial side of the foot,and freed the pedicle with the perforating vessel branches at the metatarsal neck on the medial side of the first metatarsophalangeal joint,and separated under the deep fascia,only the blood vessel pedicle retained to connect the flap.After that,the flap was reversed to cover the soft tissue defect of the forefoot.[Results]All 14 patients got flaps survived completely,with skin grafts survived well on the donor site,and followed up for 9 months to 3 years.The surviving flaps were soft in texture without obvious swelling.During the follow up period,no flap trimming was performed in anyone of them,due to satisfactory appearance of the flaps with on impacting on shoe wearing.[Conclusion] This retrograde transfer of medial foot perforator flap to repair forefoot soft tissue defects is safe and reliable,with less injury to the foot donor area,does achieve the satisfactory appearance and good functional recovery of the affected foot after surgery.