带腓肠神经营养血管蒂逆行岛状皮瓣修复下肢软组织缺损的临床研究

目的探讨腓肠神经营养血管逆行岛状皮瓣修复小腿下1／3、踝、跟、足部软组织缺损的临床应用效果。方法以腓肠神经及其营养血管为蒂,根据创面大小,在小腿后侧切取皮瓣,逆行转移修复小腿下1／3、踝、跟、足部软组织缺损31例,切取皮瓣范围5cm×6cm～12cm×1cem,观察术后皮瓣成活情况。结果术后26例（83．9％）逆行皮瓣全部成活,5例远端浅表或部分坏死,经换药、Ⅱ期清创缝合或植皮后创面愈合。结论腓肠神经营养血管逆行岛状皮瓣操作技术简便、易行、不需要吻合血管、不牺牲主要血管,成活率高,便于各级医院开展。

The surgical effect of applying reverse sural neuro-fasciomusculocutaneous flap to rehabilitate limb parenchyma wound

Objective To evaluate the surgical effect of applying reverse sural neurofasciomusculocutaneous flap to rehabilitate limb parenchyma wound.Methods Assess the size of wound on limb,cut incisor flap from posterior crus,then use sural nerve and nutrient vessel as pedicel.The flag was reversely transfened to rehabilitate limb wound.There are 31 cases with parenchyma wounds,include in lower 1/3 crus wound,ankle wound,heel wound,and foot wound.The size of flap is range from 5cm×6cm to 12cm×17cm.Observe survival rate of surgical flap.Results 26 cases(83.9%)of surgical flag are alive,while 5 cases occurred necrosis on distal superficial flag or part of the flag.The five cases finally healing through secondary suture and skin-grafting.Conclusion As a new surgery therapy,applying reverse sural neuro-fasciomusculocutaneous flap to rehabilitate limb parenchyma wound is effective.It is character with simple,available,do not need to anastomose vessel,reserve main vessel and high survival rate.So it is worth recommend to widely use in clinical practice.