小腿双蒂筋膜皮瓣治疗胫前瘢痕溃疡

COVERAGE OF PRETIBIAL SKIN DEFECTS WITH BIOPEDICLE FLAPS

应用小腿双蒂皮瓣覆盖胫前方皮肤缺损5例,均取得了满意效果。在小腿皮下、深筋膜浅层有筋膜血管丛分布于整个小腿区,并与皮下血管丛相连。由胫前、后动脉分支的穿通支及与小隐神经、腓肠神经及其交通支相伴行的小隐动脉、腘动脉皮肤支等轴型血管均与筋膜血管丛相连。因此,在小腿筋膜深层进行手术是安全的。文中还就手术方法进行了介绍。

Extensive loss of skin covering the anterior tibia may occur after trauma and in association with tibial osteomylitis.Using bipedicle flaps to cover the pretibial skin defect in 5 cases is reported.The results are satisfactory.The procedure of this operation is described.Under the skin of legs,but superficial to the fascia the fascial vascular plexus is distributed all over the leg,and it is communicated with the subdermal plexus,which is connected with perforating arteries arising from anterior and posterior tibial arteries and axial type vessels coming down along the line of saphenous nerve,sural n.and sural communicating n.These arteries are saphenous artery and cutaneous branch of the poplitial artery.The surgical plane in the leg lying deep to the deep fasia is a safe plane.