逆行腓肠神经营养血管蒂带薄层肌肉岛状皮瓣修复胫骨慢性骨感染缺损创面

目的探讨逆行腓肠神经营养血管蒂带薄层肌肉岛状皮瓣修复胫骨慢性骨感染缺损创面的方法及临床疗效。方法应用腓肠神经营养血管蒂岛状筋膜肌皮瓣逆行转位修复12例胫骨慢性骨髓炎后骨缺损并骨外露患者,皮肤软组织缺损为9~16 cm~2。结果 12例均获得随访,时间16~72个月。12例转移肌皮瓣均一期存活,伤口愈合时间14~21 d。1例肌皮瓣静脉回流障碍,行网状打孔并以肝素钠溶液冲洗网孔1周后皮瓣成活;1例皮瓣边缘部分坏死,经换药3周后愈合;所有感染均治愈。结论应用腓肠神经营养血管蒂岛状筋膜肌皮瓣逆行转位修复胫骨慢性骨髓炎后骨缺损并骨外露疗效理想。

Treatment of the wound of bone defect and exposure in chronic infection of tibia with the myofascial and cutaneous island flap pedicled with collateral vessel nourished by retrograde sural nerve

Objective To explore the therapeutic effects of myofascial and cutaneous island flap pedicled with collat-eral vessel nourished by retrograde sural nerve for the wound of bone defect and exposure in chronic infection of tibia. Methods 12 cases of tibia chronic osteomyelitis combined with bone defect and exposure were treated with myofas-cial and cutaneous island flap pedicled with collateral vessel nourished by retrograde sural nerve. The area of the tis-sue defect ranged from 9 cm2 to 16 cm2 . Results 12 cases were followed up for 16 ~72 months. All flaps survived after operation and the flaps had survived within 14 to 21 days. 1 flap with venous drainage barriers survived by net punching and heparin sodium solution flushing mesh flaps in a week, 1 flap with margin necrosis was healed with dressing change after 3 weeks;all infections were cured. Conclusions Treatment of bone defect and exposure in tibi-a with the myofascial and cutaneous island flap pedicled with collateral vessel nourished by retrograde sural nerve is an effective technique.