改良小腿内侧筋膜蒂皮瓣的临床应用和筋膜蒂位置分区的研究

目的 讨论在小腿不同分区内改良小腿内侧筋膜蒂皮瓣的设计及临床效果. 方法 自2005年1月至2008年2月,将小腿均分为三个区,按皮瓣筋膜蒂位置的分区不同分别采用逆行或顺行的改良小腿内侧筋膜蒂皮瓣修复膝前、小腿及足踝部软组织缺损45例.皮瓣面积最大25.0 cm×10.0cm,最小5.0 cm×3.0 cm. 结果 43例皮瓣完全成活,创面一期愈合;小腿上1/3内有2例皮瓣远端部分坏死,经换药后愈合.术后随访4～20个月,皮瓣颜色及质地好,外形及功能恢复满意. 结论 改良小腿内侧筋膜蒂皮瓣设计灵活、切取简单,不牺牲主干血管,血供可靠,可根据皮瓣筋膜蒂位置的不同选择合适皮瓣,是一种修复下肢软组织缺损的理想皮瓣.

Clinical application of the modified medial fascia pedicel flap of the lower leg and the research of the zonation of the fascia pedicel's location

Objective To investigate the design and clinical result of the modified medial fasciocutaneous flap of lower leg in the different zonation. Methods The length of lower leg was divided into three zonations equally.According to the different zonation of the fasciocutaneous flap,the 45 patients were divided into three groups from Jan.2005 to Feb.2008.The defects of the patients were repaired with the flaps.The sizes of the flaps ranged from 5 cm×3 cm to 25 cm×10 cm.Results The flaps survived completely in 43 cases.The distal sides of flaps necrosed partially in 2 cases in the upper third of the lower leg.The necrosed part of the flap was repaired after the change dressings.The colour and texture of flaps were excellent,the appearance and function were satisfactory after a follow up of 4-20 months.Conclusion The modified medial fasciocutaneous flap of the lower leg is easy to design and dissect,blood supply is reliable without sacrifice of the major arteries.The flap can be used according to the different location of the fascia pedicel.It is the idea flap to repair the soft tissue defects of the front of knee joint,the leg,the ankle and the foot.