胫后动脉穿支皮瓣修复足部软组织缺损

目的总结内踝上胫后动脉穿支带蒂皮瓣修复足部软组织缺损的临床应用结果。方法 2006年10月至2012年10月,应用内踝上胫后动脉穿支带蒂皮瓣修复9例足部软组织缺损,年龄16~52岁,平均35岁。软组织缺损的面积5.5 cm×3.5 cm~13.0 cm×6.0 cm。供区创面行一期全厚网状游离植皮。3例皮瓣携带的隐神经在足部与腓肠神经吻合。结果所有的皮瓣完全成活,取得了满意的临床效果。随访1.5~4年,平均随访2.5年,皮瓣恢复了感觉,两点分辨觉为6~9 mm,受区未发生溃疡。结论胫后动脉穿支带蒂皮瓣具有血管解剖恒定、血运丰富以及操作简单等优点,适宜修复足部软组织缺损。

Repairation of Soft Tissue Defect of the Foot with the Perforators Flaps of the Posterior Tibial Ar-tery

Objective To summarize clinical application of the repair soft tissue defect of the foot with the pedicle perfo-rators flaps of the posterior tibial artery. Methods Nine pedicle perforators flaps of the posterior tibial artery were used to re-pair soft tissue defect in the foot. They ranged in age from 16 to 52 years（mean,35y）. The sizes of soft tissue defect ranged from 5. 5 cm ＆#215; 3. 5 cm to 13 cm ＆#215; 6. 0 cm. The donor sites of the flaps were closed by a meshed full thickness skin graft. Three cases with saphenous nerve of the flap was anastomosed to the sural nerve at the foot. Results All flaps had survived com-pletely and satisfactory clinical results were obtained. The follow-up period ranged from 1. 5 to 4 years（mean,2. 5 y）. The flaps recovered from sensate. The two-point discriminations of the flaps ranged from 6 mm to 9 mm. No ulceration was found at the recipient site. Conclusion The advantages of the perforators flaps of the posterior tibial artery include a constant vascular anastomy,highly vascularity,simple procedure and suitable for repair of soft tissue defect in the foot.