带隐神经交腿随意皮瓣修复足底皮肤缺损

Plantar skin defects repaired by random flap with saphenous nerve

目的 报道用带隐神经的小腿内侧带蒂随意皮瓣修复对侧足底皮肤缺损的临床效果。 方法 在健侧小腿内侧隐神经走行区设计皮瓣 ,将隐神经保留在皮瓣中央 ,根据患足创面大小切取皮瓣 ,带深筋膜 ,蒂保留在胫前侧 ,将皮瓣缝合于患足的创面 ,皮瓣中的隐神经与患足足底内侧皮神经吻合 ,双下肢固定 3周后断蒂。 1997～ 2 0 0 1年 ,临床应用 13例。 结果 用该皮瓣修复 13例足底皮肤缺损均获得成功 ,皮瓣外形良好 ,术后 6～ 12个月恢复感觉 ,无再破溃发生。 结论 带隐神经交腿随意皮瓣切取简单 ,厚薄适度 ,不损伤知名血管 ,术后带感觉神经可恢复皮瓣的感觉 ,有效防止皮瓣再破溃 ,是修复足底皮肤缺损的较好方法。

Objective To introduce a new method which can be used to repair the opposite plantar skin defects by random flap with saphenous of medialshank. Methods Flap was designed in the medialshank along the saphenous, the saphenous was remained in the center of flap. Based on the size of wound to cut the flap, pedicle was remained in the front of tibia, the flap wes sutured to the wound, saphenous of flap was anastomosed with nerve cutaneus plantaris medialis of the wounded foot, pedicle was cut off after two legs had been crossfixed for 3 weeks. Results Thirteen patients with plantar skin defects were repaired with this kind of flap all flaps were primary healing, the appearance of flaps were satisfactory, the sensation recovered and flaps were not festered again in 6～12 months postoperatively. Conclusions Random flap with saphenous has advantages as follows: simply procedure, appropriate thickness, good recovery of sensation, avoidance of sacrificing major arteries and using vascular anastomoses, no fester of flap. So it is a good method to repair plantar skin defects.