腓肠神经伴行血管蒂逆行岛状皮瓣的临床应用

目的探讨腓肠神经伴行血管蒂逆行岛状皮瓣的，瞄床应用效果。方法从2000年起应用腓肠神经伴行血管蒂逆行岛状皮瓣移位修复踝部皮肤软组织缺损15例，足跟足背部皮肤软组织缺损20例。切取皮瓣范围3cmX4．5cm～8cmx15cm，血管蒂长6～15cm。结果术后52例皮瓣成活，5例部分边缘坏死。其中28例伤口I期愈合，7例经换药后愈合。55例均获随访，时间2～24个月，外观功能恢复良好，皮肤质地接近正常，6个月后感觉大部恢复。结论腓肠神经伴行血管蒂逆行岛状皮瓣血供可靠，转移范围大，损伤小，操作简便，可用于修复踝部及足跟足背部皮肤软组织缺损部，对已有主要血管损伤的病例更具有特殊意义。

Clinical Application of the Reversed Island Flap Supplied by the Vascular Axis of Sural Nerve

Objective To investigate the clinical application experience of the reversed island flap supplied by the vascular axis of sural nerve. Methods From 2000,reversed island flaps supplied by the vascttlar axis of sural nerve were performed to repair the soft tissues defects of the ankle in 15 cases, foot in 20 cases. Results 32 flaps were survived,3 flaps were partially necrosed. Among them,28 wounds healed by first intention,7 cases were healed after changing dressing.35 cases were followed up for 2-24 months and fine appearance and function. The flaps texture were similar to normal skin, the sensation of flaps partially recovered after 6 months. Conclusion The flap has more reliable blood supply and great rotation arc ,it is easy to resect with little injury. It is excellent for repairing the soft tissues defect in the ankle and proximal half of foot. It is more significant while the main blood vessels are damaged.