小腿皮神经营养血管蒂逆行皮瓣的临床应用

Clinical application of retrograde-flow neurocutaneous vascular flaps from crus

目的 探讨小腿皮神经营养血管蒂逆行皮瓣临床应用的效果。 方法 对 2 6例小腿下段及足踝部皮肤软组织缺损采用带腓肠神经、隐神经及腓浅神经营养血管蒂的逆行皮瓣修复 ,皮瓣面积最大 3 0 .0cm× 10 .0cm ,最小 6.0cm× 4.5cm ,皮神经营养血管蒂长 3～ 13cm。 结果 2 4例皮瓣全部成活。 2例因静脉回流障碍 ,皮瓣远端部分坏死。 2 1例经 6～ 3 6个月随访 ,皮瓣质地优良 ,外形与功能改善满意。 结论 小腿皮神经营养血管蒂逆行皮瓣设计灵活 ,切取方便 ,血供可靠 ,不损伤主干血管 ,可重建感觉功能 。

Objective To explore the clinical application of retrograde flow neurocutaneous vascular flaps (RNVF) from the crus. Methods Soft tissue defects on the ankle, the foot and the lower leg in 26 patients were repaired with RNVF that contained the sural nerve, the saphenous nerve and the superficial peroneal nerve nutritional vessels. The size of flaps ranged from 30.0 cm×10.0 cm to 6.0 cm × 4.5 cm .The length of pedicles was 3 13 cm. Results The flaps completely survived in 24 cases. Distal flap was partly necrotic in 2 cases because of vein drainage disturbance. In 21 cases, the color and the texture of flaps were good and the appearance and the functional results satisfactory after 6 36 months follow up. Conclusions RNVF is characterized by delicate designation, easy dissection and reliable blood supply. Sensation function can be reconstructed without damage to the major arteries. It is very useful in repairing big soft tissue defects of the lower leg, and the ankle.