缝接神经的腓肠肌内侧头动脉穿支皮瓣游离移植修复手足部软组织缺损

Hand and foot soft tissue defects repaired with free transplantation of medial surae artery perforator flap with sutured nerve

目的探讨缝接神经的腓肠肌内侧头动脉穿支皮瓣游离移植修复手足部软组织缺损的临床效果。方法采用缝接神经的腓肠肌内侧头动脉穿支皮瓣游离移植修复9例手足部软组织缺损患者。创面面积6 cm×3 cm~14 cm×12 cm,皮瓣面积7 cm×4 cm~15 cm×13 cm。结果患者均获得随访,时间3~48个月。9例皮瓣均成活。受区无感染发生。末次随访时,皮瓣色泽良好,无明显色素沉积,厚度适中,质地柔软,弹性好,耐磨,静态两点辨别觉为7~13 mm,保护性感觉恢复。结论缝接神经的腓肠肌内侧头动脉穿支皮瓣与修复创面质地接近,穿支血管解剖恒定,供区损伤小,能快速有效地获得保护性感觉,是修复手足部软组织缺损的理想方法之一。

Objective To investigate the clinical effect of free transplantation of the medial surae artery perforator flap with sutured nerve in repairing soft tissue defects of hands and feet.Methods The 9 cases of soft tissue defects of hands and feet were repaired by free transplantation of medial surae artery perforator flap with sutured nerve.The wound area was 6 cm×3 cm~14 cm×12 cm,and the flap area was 7 cm×4 cm~15 cm×13 cm.Results All patients were followed up for 3~48 months.All 9 cases of skin flaps survived.No infection occurred in the recipient area.At the last follow-up,the skin flap had good color,no obvious pigmentation,moderate thickness,soft texture,good elasticity,wear resistance,static two-point discrimination was 7~13 mm,and postoperative protective sensory recovered.Conclusions The medial surae artery perforator flap with sutured nerve is close to the texture of the repaired wound,the perforator vessel anatomy is constant,the donor area is less damaged,and the protective sensation can be obtained fastly and effectively.It is one of the ideal methods to repair the soft tissue defects of hands and feet.