应用不同部位游离穿支皮瓣修复小腿远端足踝部软组织缺损

目的探讨游离股前#l,f14、胸背动脉、腹壁下动脉穿支皮瓣修复小腿远端足踝部软组织缺损的手术技术及效果。方法对19例小腿远端足踝部皮肤软组织缺损患者进行修复，皮肤缺损面积（6emx9cm）～（11．6em~22．3em）。其中股前外侧穿支皮瓣12例、胸背动脉穿支皮瓣4例、腹壁下动脉穿支皮瓣3例。结果术后19例皮瓣全部成活。术后随访3—18个月，平均8．2个月，皮瓣颜色质地好，外形满意，两点辨别觉为9—21mm。结论游离股前外侧、胸背动脉、腹壁下动脉穿支皮瓣修复小腿远端足踝部软组织缺损临床效果满意。

Different Parts of Free Perforator Flaps for Repairing Soft Tissue Defects of Lower Leg,Ankle and Foot

Objective To explore the operative technique and clinical efficacy of free anterolateral thigh perforator flap, thoracodorsal artery perforator flap and deep inferior epigastric perforator flap in the repair of soft tissue defects of lower leg, ankle and foot. Methods Nineteen patients with lower leg, foot and ankle soft tissue defects（range, 6 em~9 cm to 11.6 cm~22.3 cm）were treated with anterolateral thigh perforator flap（12 cases）, thoracodorsal artery perforator flap（4 cases）, or deep inferior epigastrie perforator flap（3 cases ）.Results All flaps survived postoperatively in the 19 cases.After an average fol- low-up of 8.2 months（range, 3 to 18 months）, flaps had good color and quality and showed satisfactory shape. The two-point discrimination was 9-21 mm. Conclusion The clinical efficacies of free anterolateral thigh perforator flap, thoraeodorsal artery perforator flap and deep inferior epigastrie perforator flap are satisfactory for the repair of soft tissue defects of lower leg, foot and ankle.