远端蒂腓肠神经营养血管皮瓣治疗踝部及足跟部溃疡

目的总结小腿腓肠神经营养血管皮瓣修复足踝部软组织缺损的临床疗效。方法回顾分析2005年1月至2010年1月采用远端蒂腓肠神经营养血管皮瓣治疗足踝皮肤软组织缺损患者14例。结果 14例全部得到随访,随访期从手术后6个月～3年不等。12例皮瓣成活,2例皮瓣完全坏死;12例成活的皮瓣中,3例皮瓣边缘小部分坏死,1例患者1年后溃疡复发。典型病例皮瓣完全成活,随访半年,能正常行走,无相应并发症发生。结论远端蒂腓肠神经营养血管皮瓣是一种踝部及足跟部溃疡面修复的可靠皮瓣。它无需损害重要的外围脉管,且对外周脉搏弱的患者是有用的替代方法。

Distally based sural neurocutaneous flaps for ankle and heel ulcers

Objective To research the repairing methods and their clinical effects of soft tissue defects of ankle and foot with leg neurocutaneous vascular flaps.Methods From Jan.2005 to Jan.2010,14 cases of ankle and foot soft tissue defects were treated with distally based sural neurocutaneous flaps.Results Follow-up of the 14 patients included in this study ranged from 6 months to 3 years after their operation.12 flaps of 14 cases were survived,3 cases with distal edge partially necrosis.A lateral malleolus ulcer in a patient with rheumatoid arthritis recurred after 1 year.All the cases were after followed up none of them recurred.Conclusion The sural neurocutaneous flap is thus a reliable means of resurfacing ulcers in the ankle and heel region.It requires no sacrifice of major peripheral vessels and may be a useful alternative for patients with poor peripheral pulses.