腓肠神经营养血管蒂逆行岛状筋膜皮瓣临床应用8例

目的探讨应用腓肠神经营养血管蒂逆行岛状筋膜皮瓣修复足踝部软组织缺损的方法。方法应用腓肠神经营养血管蒂逆行岛状筋膜皮瓣修复踝部、足跟部软组织缺损8例,皮瓣切取范围5cm×7cm～10cm×14cm,蒂长5cm～8cm。结果本组8例术后皮瓣均成活,7例伤口一期愈合,1例皮瓣边缘表层坏死,经换药、植皮后愈合。术后5例经3个月至4年随访,皮瓣血运、质地、弹性佳,外观较满意,踝关节活动功能正常。结论腓肠神经营养血管蒂逆行岛状筋膜皮瓣设计容易,操作简便,无需牺牲知名动脉,不需吻合血管,且皮瓣可获得较长蒂部,旋转灵活,皮瓣成活率高,是足踝部软组织缺损的较好的修复方法。

Reversed sural neurovascular fasciocutaneous flap reconstructe the soft tissue defect of ankle and foot

Objective To approach the clinical effect of reversed sural neurovascular fasciocutaneous flap for reconstruction of soft tissue defect of ankle and foot.Methods Eight cases with soft tissue defects in the ankles and feet were repaired by using reversed sural neurovascular fasciocutaneous flap.The flap area ranged from 5 cm×7 cm to 10 cm×14 cm,and the length of pedicle from 5 cm to 8 cm.Results All flaps survived in eight cases.The raw surface of seven cases was healed well.Only one cases encountered with partial necrosis of marginal flap but healed after dressing and dermatoplasty.Five cases were followed up for three months to four years.The texture elasticity and appearance of the flaps were excellent,function of ankle joint was good.Conclusion Antidromic island flap providing blood supply by sural＇s nerver is easy to design.The operation is simple,and without sacrifice of major arteries,and need not to coincide blood vessel,and the flap can have longer pedicle which can be rotated actively.So it has high survival rate.It is a good method to repair the soft tissue defect of ankle and foot.