腓肠神经营养血管远端蒂皮瓣修复足踝部软组织缺损

目的：总结应用腓肠神经营养血管远端蒂皮瓣修复足踝部皮肤软组织缺损的经验。方法：从2006年2月～2008年12月，笔者应用腓肠神经营养血管远端蒂皮瓣修复足踝部软组织缺损共12例，皮瓣最大15cm×10cm，最小6cm×5cm，筋膜蒂宽度为4～5cm，皮瓣旋转点至外踝尖距离5～7cm。皮瓣剥离的深度在腓肠肌肌膜深面，将小隐静脉和腓肠神经包含于内。蒂部均留有2cm宽度的皮肤，走明道向受区旋转。结果：12例皮瓣全部成活，无供血不足及静脉回流障碍。结论：腓肠神经营养血管远端蒂皮瓣血运丰富，制作简便，防止蒂部受压是成活率高的保证。

Clinical application of distal based of sural nerve nutrient vessels flap for repairing soft tissue defects of ankle and heel

Objective To sum up the experience of clinical application of distally-based of sural nerve nutrient vessels flap for repairing soft tissue defects of ankle and heel. Methods From Feb. 2006 to Dec. 2008, there were 12 cases with foot and ankle defects were allowed to our department, all focuses were repaired with the distal based of sural nerve nutrient vessels flap. the size of flaps ranged from 15cm×10cm to 6cm×5cm, the width of the fascia pedicle was 4-5cm and the distance between the pivot point and the lateral malleoli was 5-7cm. The extensive dissection of flap should be done blow the gastrocnemius sarcolemma, the sural nerve and lesser saphenous vein should be included in the flap at the same time. 2cm width of skin on the surface of piddle was keep and the flap was rotated to the recipient site in open tunnel. Results Satisfactory results were achieved in all 12 without unreliable blood supply and venous complication. Conclusions This treatment strategy described here could be advocated in view of its profuse blood supply, simple manipulation and few complications. The key procedure to ensure a successful result was to prevent constriction in pedicle region.