逆行腓肠神经营养血管筋膜皮瓣的临床应用

目的：探讨逆行腓肠神经营养血管筋膜皮瓣的手术方法和临床应用效果。方法：在小腿后侧设计及切取腓肠神经营养血管筋膜皮瓣，逆行修复小腿中下段及足踝部的软组织缺损，并观察皮瓣的血液供应及静脉回流情况。结果：临床应用35例，皮瓣全部成活，无明显肿胀、青紫及张力水泡，皮瓣面积5．0cm×4．0cm～20．0cm×8．0cm，术中观察腓动脉穿支的位置均在外踝上5．0～7．0cm范围内。随访12～24个月，皮瓣色泽、质地、弹性良好。结论：腓肠神经营养血管筋膜度瓣血供可靠，手术简便，可切取范围较大，是修复小腿中下段及足踝部软组织缺损的理想皮瓣。

Clinical application of fascia flap of backward sural nerve nutrition vessel

Objective： To discuss operational methods and clinical effect of fascia flap of backward sural nerve nutrition vessel. Methods：Fascia flap of sural nerve nutrition vessel was designed and cut at posterior side of shank, soft tissue defects of intermediate-inferior shank and ankle were repaired backwardly with the flap, and blood supply and venous return of the flap were observed. Results： All flaps survived among total 35 applications without obvious swelling, livor or tension vesicle. All flaps, whose area differed from 5.0 cm ×4. 0 cm to 20. 0 cm ×8. 0 cm, were observed being located 5.0～7.0 cm above lateral ankle during operation. Their color and luster,texture and elasticity maintain well during 12 to 24 months＇follow-ups. Conclusions：Fascia flap of sural nerve nutrition vessel is the ideal flap for repairing soft tissue defects of intermediate-inferior shank and ankle, with advantages such as reliable blood supply, convenient operation, and larger range to cut.