非恒定蒂腓动脉链式穿支皮瓣修复足踝部皮肤缺损19例

目的 探讨应用非恒定蒂腓动脉链式穿支皮瓣修复小腿及足踝部皮肤软组织缺损的方法及临床效果. 方法 2005 - 2010年应用非恒定蒂腓动脉链式穿支皮瓣修复小腿及足踝部皮肤软组织缺损患者19例,术前应用多普勒血流仪探测腓动脉皮支位置,利用各皮支形成的链式供血方式,选择距创面直线距离最近的皮支点作为旋转点切取皮瓣修复创面.皮瓣切取面积最大25 cm×8 cm,最小16 cm×6 cm. 结果 经1.5个月～3.5年的随访,18例皮瓣成活良好,外观满意,仅1例皮瓣远端出现边缘坏死. 结论 非恒定蒂腓动脉链式穿支皮瓣不受蒂部位置的限制,切取灵活方便,是一种修复小腿及足踝部皮肤软组织缺损的理想方法.

Clinical application of peroneal artery chain perforator flap with unsteady peduncle in repair of skin defect of ankle: a report of 19 cases

Objective To investigate the application of peroneal artery chain perforator flap in repairing skin and soft tissue defects of ankle and lower leg and the corresponding clinical effect.Methods From 2005 to 2010,19 cases of skin and soft tissue'defects of the ankle and lower leg were treated by using peroneal artery chain perforator flaps.The sites of peroneal artery branches were detected by using Doppler flowmeter before operation.Supplied by the chain form of terminal branches of the peroneal artery,the cutaneous fulcrum straightly nearest to the wound was selected as the rotation point to design the flap,with area ranging from 25 cm × 8 cm to 16 cm × 6 cm.Results The follow-up for 1.5- 42 months revealed that all cases of flap survived with satisfactory shape,except for one case suffered from distal skin flap necrosis.Conclusions The peroneal artery chain perforator flap with unsteady peduncle has no restrictions of peduncle sites and can be cut flexibly.It is a perfect method in repair of soft tissue defect of ankle and lower leg.