足背动脉皮支逆行翻转筋膜瓣修复前足创面

COVERAGE OF THE FOREFOOT SOFT-TISSUE DEFECTS WITH THE REVERSED TURN-OVER FASCIOCUTA-NEOUS FLAP BASED ON PERFORATORS OF THE DORSALIS PEDIS ARTERY

目的:根据足背皮肤的血供特点,形成较大面积的足背逆行翻转筋膜瓣,解决前足较大创面的修复问题。方法:利用足背动脉远端皮支血管供血,设计足背逆行翻转筋膜瓣,蒂部位于第一跖骨间隙中段平面,皮瓣面积最小为6cm×5cm,最大为15cm×7cm,蒂长5cm～7cm,蒂宽4cm～7cm,长宽比4.5:1～6:1。结果:临床应用23例34个皮瓣,手术全部成功,术后18例经1年以上随访,外形及功能恢复达到满意效果。结论:足背动脉皮支逆行翻转筋膜瓣可切取皮瓣面积大,不损伤足背动脉主干,为前足皮肤缺损的修复提供了简单、安全实用的方法。

Objective:A large reserved turn -over dorsalis pedis fasciocutaneous flap has been developed and used to repair soft -tissue defect of the forefoot.Methods :Supplied by the perforators of the dorsalis pedis artery ,the reversed tu rn -over dorsum of the foot adipofascial flap was designed.the flap pedicle is located the proximal half of the first interosseous space.the size of the flap ranged from6cm ×5cm to 15cm ×7cm,the base area to the flap area ratio was from 4.5:1to 6:1.Results:We have successfully treated 23cases of forefoot defects with the perforato rs of the dorsalis pedis artery reserved turn -over fasciocntaneous feap.Postoperative follow -up over one year in 18cases revealed satisfa ctory results.Conclusion:The adipofascial turn -over flap based on perforators of the dorsalis ped is artery is a very reliable,simple,an d repaid procedure for resurfacing f orefoot defects.