游离胫后动脉穿支皮瓣修复手、足背皮肤缺损

目的 探讨游离胫后动脉穿支皮瓣修复手、足背皮肤缺损的方法与疗效.方法 自胫骨粗隆平面至内外踝连线等分成6段,在近端第2、3段胫骨内缘设计皮瓣,切取胫后动脉穿支皮瓣,并携带2～3束隐神经,游离移植修复手、足背皮肤缺损,缺损面积:3.0cm×7.5 cm～6.0 cm×12.0 cm.结果 2009年1月至2010年12月,临床应用11例,皮瓣完全成活.随访3～10个月,皮瓣质地柔软,色泽红润,两点辨距觉达7～10 mm,小腿供区只存留较小的线状切口瘢痕,功能及外形均较满意.结论 胫后动脉穿支皮瓣不损伤胫后动脉主干,皮瓣薄且供区相对隐蔽,感觉可部分或全部恢复,是修复手、足背皮肤缺损的较理想术式.

Application of free posterior tibial artery perforator flap for skin defect on the dorsum of hand or foot

Objective To summarize the technique and therapeutic effect of free posterior tibial artery perforator(PTP) flap for skin defect on the dorsum of hand or foot.Methods The lower leg was divided into 6 sections equally from the level of tibial tuberosity to the connection of medial and lateral malleolus.The free PTP flap was designed along the inner edge of tibia within the proximal section 2 and 3.The flap was harvested with 2-3 bundles of the saphenous nerve included.The size of skin defects on the dorsum of hand or foot ranged from 3.0 cm × 7.5 cm to 6.0 cm × 12.0 cm.Results From Jan.2009 to Dec.2010,11 cases were treated with free PTP flaps.All the flaps survived completely.The follow-up period ranged from 3 to 10 months.The flaps had good color and texture.Two point discrimination recovered to 7-10 mm,leaving linear scar at the donor site.The apperance and function of the hand or foot was satisfactory.Conclusions The free PTP flap is thin with good sensation,leaving less morbidity at donor site.The posterior tibial artery can be reserved.It is an ideal method for skin defect on the dorsum of hand or foot.