带小隐静脉及足背外侧皮神经的跟外侧动脉轴型皮瓣修复足跟部软组织缺损

目的探讨跟外侧动脉供血的带小隐静脉及足背外侧皮神经的足外侧轴型皮瓣修复足跟部伴骨骼、肌腱外露的深度小创面的价值。方法以外踝与跟腱连线中点弧形向前至第5跖骨头为皮瓣轴心线，向两侧延伸形成皮瓣，以外踝与跟腱水平连线中点为皮瓣旋转轴点，按足跟部创面面积、形状设计皮瓣。皮瓣长宽较创面大1～1．5cm，旋转点到皮瓣距离较至创面距离长2～3cm。皮瓣最大面积8cm×6cm，最小6cm×3cm。共修复足跟部深度小创面12例。结果12例皮瓣全部成活，皮瓣血运良好，感觉恢复好，患足功能良好，远期无压疮及溃疡形成。结论以跟外侧动脉供血的带浅静脉及皮神经的足外侧皮瓣血运好，皮瓣的成活率与质量高。术后皮瓣感觉恢复好，耐磨，远期无压疮及溃疡形成，是修复足跟部伴骨骼、肌腱外露小创面的理想皮瓣。

Clinical application of axial fasciocutaneous flap based on lateral artery of heel with lateral dorsal cutaneous nerve of foot and small saphenous vein to repairing tissue defects of heel

Objective To explore the clinical application of axial fasciocutaneous flap based on lateral artery of heel with lateral dorsal cutaneous nerve of foot and small saphenous vein to the repair of the soft tissue defects of heel. Methods A total of 12 cases of soft tissue defect of heel caused by burn or trauma designed to be repaired with the axial fascioeutaneous flap based on the lateral artery of heel with lateral dorsal cutaneous nerve of foot and small saphenous vein. The flap＇ s axis point lay at the middle from lateral malleolus to tendo calcaneus and the flap was harvested according to the line from the middle point to tuberosity of fifth metatarsal bone. The length and width of flap was 1 - 1.5 cm greater than the wound. The distance between the point of rotation and flap was 2 - 3 cm longer than between the point and the wound. The maximum flap size was 8 cm× 6 cm, minimum 6 cm× 3 cm. Results All of the 12 flaps survived completely and the blood circulation of the flaps was good. Conclusion The axial fasciocutaneous flaps based on the lateral artery of heel have enough blood supply and survive well. They are suitable for the repair of the soft tissue defects of heel with bone or tendon exposure.