足背动脉内侧筋膜支为蒂的足内侧皮瓣移植

目的报道足背动脉内侧筋膜支为蒂的足内侧皮瓣的设计及临床应用结果。方法对足内侧区皮肤筋膜血供的进一步观测,发现足背动脉内侧筋膜支恒定,为该区的重要血供来源。据此设计了可达１０ｃｍ×８ｃｍ的足内侧皮瓣。临床用于修复足背、踝部、前足、小腿下端及手部软组织缺损１８例。结果术后皮瓣全部成活,效果良好,供区损害轻。结论足背动脉内侧筋膜分支是足内侧皮瓣的可靠血管蒂。该皮瓣是修复足背、踝部、小腿下端及前足软组织缺损的一种理想的组织瓣。     

足背动脉内侧筋膜支为蒂的足内侧皮瓣移植

目的报道足背动脉内侧筋膜支为蒂的足内侧皮瓣的设计及临床应用结果。方法对足内侧区皮肤筋膜血供的进一步观测,发现足背动脉内侧筋膜支恒定,为该区的重要血供来源。据此设计了可达10cm×8cm 的足内侧皮瓣。临床用于修复足背、踝部、前足、小腿下端及手部软组织缺损18例。结果术后皮瓣全部成活,效果良好,供区损害轻。结论足背动脉内侧筋膜分支是足内侧皮瓣的可靠血管蒂。该皮瓣是修复足背、踝部、小腿下端及前足软组织缺损的一种理想的组织瓣。     

带跗内侧动脉的足背动脉岛状皮瓣的应用

目的 足踝部组织缺损的修复。方法 用带跗内动脉的足背动脉岛状皮瓣修复足踝部组织缺损。结果 本组５例中，４例术后皮瓣全部成活，１例成活１／２，再行游离皮片移植后愈合，平均随访２１月，无疤痕溃破及疼痛。结论该皮瓣转移范围及切取范围均较大，皮瓣坚韧致密，取瓣区隐匿且不影响负重及行走，用于足踝部缺损修复效果较好。     

足背动脉皮支逆行翻转筋膜瓣修复前足创面

目的:根据足背皮肤的血供特点,形成较大面积的足背逆行翻转筋膜瓣,解决前足较大创面的修复问题。方法:利用足背动脉远端皮支血管供血,设计足背逆行翻转筋膜瓣,蒂部位于第一跖骨间隙中段平面,皮瓣面积最小为6cm×5cm,最大为15cm×7cm,蒂长5cm～7cm,蒂宽4cm～7cm,长宽比4.5:1～6:1。结果:临床应用23例34个皮瓣,手术全部成功,术后18例经1年以上随访,外形及功能恢复达到满意效果。结论:足背动脉皮支逆行翻转筋膜瓣可切取皮瓣面积大,不损伤足背动脉主干,为前足皮肤缺损的修复提供了简单、安全实用的方法。     

足底内侧动脉分支蒂皮瓣的临床研究

目的 探讨以足喊内侧动脉分支为蒂皮瓣的设计及临床应用效果。方法 在解剖基础上以足底内侧动脉及其分支为血管蒂，设计足内侧皮瓣、足底内侧皮瓣、联合皮瓣及双叶皮瓣顺、逆行转位或游离移植修复53例于足部皮肤缺损创面。结果 临床应用53例，51例皮瓣完全成活。45例术后随访6～24个门，皮瓣质地优良，手、足外形与功能改善满意。结论 该类皮瓣切取方便，血供可靠，厚薄适中，外形佳，足修复手、足部皮肤缺损的理想选择。双叶皮瓣及逆行皮瓣为临床提供了实用性的新方法。     

足底内侧动脉浅支为蒂的游离足内侧穿支皮瓣修复手腕掌部深度软组织缺损

目的 探讨足底内侧动脉浅支为蒂的游离足内侧穿支皮瓣修复手腕掌部深度软组织缺损的疗效.方法 采用足底内侧动脉浅支为蒂的游离足内侧穿支皮瓣修复4例手腕掌部深度软组织缺损患者.皮肤软组织缺损面积4.5 cm×3.5 cm～10.5 cm×4.5 cm,皮瓣切取面积5.0 cm×4.0 cm～11.0 cm×5.0 cm,供区...     

足背逆行筋膜蒂皮瓣修复(足母)趾缺损

目的为     

以足背动脉为蒂的多种皮瓣转位修复足拇趾复合性组织缺损

目的 探讨以足背动脉为蒂的多种皮瓣转位修复拇趾复合性组织缺损的临床疗效.方法采用以足背动脉为蒂的踝前皮瓣、跗外侧动脉、跗内侧动脉及足背动脉皮瓣转位修复足部拇趾皮肤复合性组织缺损48例.结果获3～12个月,平均5个月的随访.42例成活,皮瓣外形优良,两点瓣别觉8～11mm.结论 以足背动脉为主干的多种皮瓣转位修复足拇趾...     

上臂内侧筋膜皮瓣的临床应用

目的　探讨上臂内侧由肱动脉肌间隔皮支供血的筋膜皮瓣的临床应用。方法　 1994年以来 ,应用由肱动脉内侧肌间隔皮支供血的上臂内侧筋膜皮瓣修复腋窝、肘关节屈侧瘢痕挛缩和胸前放射性溃疡 18例。其中顺行皮瓣 3例 ,逆行皮瓣 15例 ;皮瓣最大范围为 2 3 cm× 11cm ,最小为 10 cm× 6 cm。结果　术后皮瓣全部成活 ,肘部及腋窝功能、外形良好。结论　上臂内侧筋膜皮瓣薄 ,质地柔软 ,无毛 ,适合修复腋窝及肘关节部位软组织缺损 ,且手术操作简便 ,血供可靠。     

Combined medialis pedis and medial plantar fasciocutaneous flaps based on the medial plantar pedicle for reconstruction of complex soft tissue defects in the hand

The reconstruction of complex soft tissue defects in hands remains a difficult challenge in reconstructive surgery. In this report, we introduce a combined medialis pedis and medial plantar fasciocutaneous flaps supplied by the lateral and medial branches of the medial plantar artery, which allows a one-stage reconstruction of multiple soft tissue defects in hand. Three combined medialis pedis and medial plantar fasciocutaneous flaps were transferred for repair of the soft tissue defects including palmar and dorsal areas of hand, thumb pulp, and the dorsum of index finger in three patients. All three flaps survived uneventfully with coverage matching the texture and color of the recipients. The donor sites healed without complication. The experience from these cases proves that the combined medialis pedis and medial plantar fasciocutaneous flaps based on the medial plantar pedicle would be a valuable alternative for the reconstruction of complex soft tissue defects in the hand.     

Sensate sole-to-sole reconstruction using the combined medial plantar and medialis pedis free flap

The coverage of soft-tissue defects of the sole needs special consideration because of the forces of weight bearing on the reconstruction. A variety of free tissue transfers have been advocated for soft-tissue replacement of the weight-bearing portions. However, there is no doubt that the ideal tissue for resurfacing the sole is the plantar tissue itself. The authors present a case of reconstructing the sole with the combined medial plantar and medialis pedis free flap that involves approximately 70% of the weight-bearing portion. This contralateral, combined fasciocutaneous free flap based on the posterior tibial-medial plantar vascular system is a good alternative in covering extensive sole injuries.     

指动脉终末背侧支逆行皮瓣

目的：介绍用指动脉终末背侧支逆行皮瓣修复指端软组织缺损及覆盖裸骨的疗效。方法：应用指动脉终末背侧支血管蒂的中节指背皮瓣逆行转移修复指端软组织缺损5例。结果：术后皮瓣全部存活，外形满意。结论：该术式是目前临床上以最纤细血管分支命名的血管蒂皮瓣之一，可避免损伤指固有血管，手术简便。     

足底内侧动脉穿支蒂足背内侧皮神经逆行皮瓣的应用

目的 探讨足底内侧动脉穿支蒂足背内侧皮神经营养血管逆行岛状皮瓣的临床应用效果.方法 2005年6月至2008年3月;应用以足底内侧动脉穿支为蒂的足背内侧皮神经营养血管逆行岛状皮瓣修复足前端软组织缺损12例,皮瓣切取面积3.0 cm×3.5 cm～5.5 cm×8.5 cm.结果 12例皮瓣全部成活,供区创面也愈合顺利.经随访6～24个月,皮瓣质地、弹性均正常,无溃疡发生,感觉获得一定恢复,两点辨别觉为7～10 mm,外观及功能满意.供区创面也顺利愈合.结论 该皮瓣扩大了切取面积和修复范围,具有手术操作相对简单、安全,不损伤主要血管,皮瓣厚薄适中,弹性好,耐磨,色泽与受区一致的优点.     

Reconstruction of finger-pulp defect with a homodigital laterodorsal fasciocutaneous flap distally based on the dorsal branches of the proper palmar digital artery

Objective

The purpose of our study was to introduce the surgical procedure and long-term follow-up of finger-pulp defect treated with the homodigital laterodorsal fasciocutaneous flap, which is based on the dorsal branches of the proper palmar digital artery.

Methods

Seven cases with finger-pulp defect, which were treated by the homodigital laterodorsal fasciocutaneous flap based on the dorsal branches of the proper palmar digital artery, were involved in this study. The defect size ranged from 14.5 mm × 14.5 mm to 24.5 mm × 16.5 mm. Average duration of follow-up was 12 months (range, 10–36 months). Standardised assessment of outcome in terms of the defect size of finger-pulp, survival size of the flap, the static and moving two-point discrimination, time of returning to work and subjective assessment (satisfactory, good and very good) was completed.

Results

All flaps in this series survived uneventfully. No loss of the flap in this series was noted. The average size of the flaps was 18.43 mm × 15.28 mm. The flaps had a good appearance, texture and blood circulation. The average static two-point discrimination and moving two-point discrimination of the flaps were 4.5 mm (range, 4–6 mm) and 4.3 mm (range, 3–6 mm). All patients were content with the aesthetic and functional outcome of the surgery, and returned to their original job after an average of 4 weeks (range, 3–8 weeks) postoperatively.

Conclusion

The homodigital laterodorsal fasciocutaneous flap based on the dorsal branch of the proper palmar digital artery is an ideal alternative to reconstruct the finger-pulp for single-stage reconstruction without sacrificing the proper palmar digital artery and nerve.     

Combined medialis pedis and medial plantar fasciocutaneous flaps for coverage of soft tissue defects of multiple adjacent fingers

Soft tissue defects of adjacent multiple fingers covered by a single large flap require secondary separation of the flap into each finger. Such covering obstructs independent motion of injured fingers until the single large flap is separated. This report describes the technique of combined medialis pedis and medial plantar fasciocutaneous flaps for reconstructing soft tissue defects of multiple adjacent fingers. Three male patients (age range, 18–33 years) underwent soft tissue reconstructions of multiple adjacent fingers with combined flaps. Injuries involved three adjacent palmar fingers, two adjacent palmar fingers, and two adjacent dorsal fingers. Average sizes of the combined flaps were 4.2 × 4.0 cm for the medialis pedis flap and 3.0 × 1.8 cm for the medial plantar fasciocutaneous flap. All flaps survived without vascular complications, and donor sites healed uneventfully. All patients experienced excellent recovery of range of motion for the reconstructed fingers. In conclusion, combined flaps may offer an alternative for coverage of soft tissue defects that involve multiple adjacent fingers. © 2014 Wiley Periodicals, Inc. Microsurgery 34:454–458, 2014.     

吻合血管的足内侧,第一跖背,足外侧三叶皮瓣的临床应用

目的：为修复多指皮肤缺损而设计了足内侧，第一趾背、足外侧的三叶皮瓣。方法：在解剖学研究的基础上，设计以胫前、足背血管为主干，跗内侧、第１跖背、跗外侧血管为分支，构成足内侧、第１跖背、足外侧的三叶皮瓣，游离移植修复多指皮肤同时缺损。结果：临床应用４例，３例三叶皮瓣全部成活，１例皮瓣有二叶坏死。结论：足内侧、第１跖背、足外侧三叶皮瓣游离移植的应用成功，为临床多指皮肤缺损的修复，提供了一种新的术式     

吻合血管的足底内侧及足内侧双叶皮瓣的临床应用

目的 报道游离足底内侧及足内侧双叶皮瓣修复手部皮肤缺损的手术方法及临床效果,方法,在解剖研究的基础上设计以足底内侧血管为主干,带其主干支及足内侧区皮穿支构成足底内侧非负重区,足内侧区双叶皮瓣,游离移植同时修复手或手指两处皮肤缺损。