逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

目的 探讨逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损的方法.方法 2004年1月至2008年10月,采用逆行足内侧隐神经营养血管皮瓣修复足前部软组织缺损15例,皮瓣最大面积8 cm×5 cm,最小3.5 cm×3.0 cm.供区移植皮片覆盖.结果 术后所有皮瓣全部成活,10例获随访1～9个月,皮瓣色泽、质地、外形良好.患足行走正常,皮瓣及供区无溃疡发生.结论 应用逆行足内侧隐神经营养血管皮瓣修复足前部皮肤软组织缺损,血供可靠,操作简单,创伤小.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损

Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects at forepart of feet. Methods From January 2004 to October 2008,15 cases of skin defects at forepart of feet were repaired with reverse saphenous nerve neurocutaneous flaps. The flap size ranged from 3.5 cm × 3.0 cm to 8 cm ×5 cm. The wounds at donor site were closed with skin graft. Results All the flaps survived completely with no ulcer at the donor site. 10 patients were followed up for 1 ～ 9 months. The skin color and texture were satisfactory. The patients could walk very well. Conclusions It is reliable to repair the skin defects at forepart of feet with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity.     

三维CT血管造影辅助设计足内侧隐神经营养血管皮瓣修复足远端软组织缺损

目的探讨三维CT血管造影技术(three-dimensional computerized tomography angiography,3D-CTA)辅助设计足内侧隐神经营养血管皮瓣,逆行修复足远端皮肤软组织缺损的临床效果。方法2013年11月至2018年2月,潍坊市益都中心医院收治19例足远端缺损患者,男12例,女7例,年龄16~45岁,平均29.6岁。术前行同侧足3D-CTA检查,了解供区血管情况,明确FDA2趾底内侧动脉浅支的位置、走行、长度、与周围邻近组织关系,设计足内侧隐神经营养血管皮瓣逆行修复足远端皮肤软组织缺损创面。随访时根据Sanders等的Maryland足功能评分标准评定足、踝部功能,根据Swanson等的周围神经损伤临床效果评价标准对感觉恢复情况进行评估。结果术前采用3D-CTA均能检测到FDA2趾底内侧动脉浅支,术中所见穿支血管情况与检查图像结果显示基本一致。术后皮瓣全部成活,所有病例均得到随访,时间为6~12个月,平均8个月,皮瓣外观较好,血运可靠,足、踝部功能基本正常,穿鞋及负重无明显影响。足、踝部功能恢复达优者8例,良10例,中1例。足远端皮肤感觉恢复达S45例,S310例,S24例;感觉恢复范围达R43例,R39例,R27例。结论术前行3D-CTA检查,可以明确供区FDA2趾底内侧动脉浅支解剖情况,指导设计足内侧隐神经营养血管皮瓣逆行修复足远端皮肤软组织缺损,血供可靠,创伤小,效果满意。