腓肠内侧动脉穿支皮瓣修复上下肢创面

目的介绍吻合血管的腓肠内侧动脉穿支皮瓣修复上下肢创面的临床方法和经验。方法采用吻合血管的腓肠内侧动脉穿支皮瓣修复上下肢创面11例，女6例，男5例。皮瓣设计区域为同侧小腿，腓肠内侧肌肌腹以远1／2的表面部分，前内界为胫骨的内后缘，后外侧界为小腿后正中纵轴线，皮瓣的轴行线为前内界和后外侧界的中线。皮瓣长8～15cm，宽6～14cm。结果10例皮瓣成活，皮瓣质地柔软，富有弹性，不臃肿，恢复了一定的触觉；1例皮瓣全部坏死，经扩创、断层皮片修复创面；不影响供区的运动功能。结论腓肠内侧动脉穿支皮瓣可以用来修复上下肢创面，尤其对手足部创面的修复有较为满意的临床疗效。

Free medial sural artery perforator flap for the tissue defect in the upper Or lower limbs

Objective To report 11 cases with the tissue defects of their upper or lower limbs repaired with the anastomsed medial sural artery perforator flaps. Methods The free medial sural artery perforator flaps, with length of 8 cm to 15 cm and width of 6 cm to 14 cm were used for tissue defect reconstruction of the distal upper or lower limbs in 11 cases, including 6 females ~md 5 males. The flap was harvested from the homo-lateral calf, confined between the posterior-medial edge of the tibia and the middle line of the calf and above the distal half part of the medial sural muscle, with a same axis of this muscle. Results Ten cases survived very well, which was relatively thin, and the donor site can be acceptable. One case resulted in a complete flap necrotized and covered with a split skin graft. No obvious motor function defect was observed of the donor leg. Conclusion The anastomsed medial sural artery perforator flap is alternative donor flap for the upper or lower limb tissue defect repair, especially for the defect in the hand or foot.