交腿比目鱼肌瓣带蒂移植修复对侧小腿软组织缺损

目的:报告比目鱼肌瓣带蒂移植修复对侧小腿软组织缺损临床应用结果。方法:自2008年1月至2013年1月,应用比目鱼肌瓣移植修复对侧小腿软组织缺损8例,男7例,女1例;年龄20～49岁,平均31.8岁。损伤至手术时间:2～8周,平均46 d.肌瓣表面行Ⅰ期中厚网状游离植皮,供区直接缝合。结果:8例肌瓣全部成活,其中1例,受区创缘去除引流条后每天从引流孔有少量渗出液流出,经2周换药处理自然愈合。8例患者均获随访,时间1.5～4年 (平均2.5年).胫腓骨骨折全部愈合,受区外形较好。下肢功能按LEM标准评定,优2例,良5例,尚可1例。结论:比目鱼肌瓣带蒂移植很适宜伤肢仅有1条主要血管伴有软组织缺损的修复,可以减轻对供区的损伤。

Application of cross-leg soleus muscle flap transplantation to treat the soft-tissue defect in contralateral leg

Objective:To summarize the clinical application results of the repair soft tissue defect in contralateral leg with a cross-leg soleus muscle flap pedicle transplantation. Methods:From January 2008 to January 2013,8 patients with soft-tissue defect in lower leg underwent reconstruction with a cross-leg soleus muscle flap pedicle transplantation(without microvascular anastomoses). There were 7 males and 1 female,aged from 20 to 49 years old with an average of 31.8 years. The operative time after injury was from 2 to 8 weeks with the mean of 46 days. The soleus muscle flap was transposed across to the contralateral leg defect area,then immediate to perform the coverage of the muscle flaps by a meshed split-thickness skin graft. The donor site was closed directly. Results:All the muscle flaps had survived completely. In one case,recipient area edge had a less exudate from drainage hole everyday,the incision spontaneously was healed after 2 week's changing dressing. Follow-up period ranged form 1.5 to 4 years with an average of 2.5 years postoperatively. The tibia and fibula fractures were healed well. A good contour was achieved at the recipient area. According to LEM standard,2 cases got excellent results,5 good and 1 fair. Conclusion:Soleus flap pedicle transplantation is very suitable to repair the soft tissue defect of the injuried leg only one main blood vessel,and can reduce the damage of donor area.