内踝上逆行岛状皮瓣修复足踝部皮肤软组织缺损

目的：探讨内踝上逆行皮瓣修复足踝部皮肤软组织缺损的方法及疗效。方法：应用内踝上逆行皮瓣转移修复16例由外伤、感染所致足踝部皮肤软组织缺损并骨外露或跟腱外露。修复皮肤软组织缺损最大面积7cm×10cm。结果：术后皮瓣完全成活15例，尖端部分坏死1例，2期行植皮覆盖坏死区。术后经1～12个月随访，修复后皮瓣皮肤质地、厚度与足踝部相接近，皮瓣痛、触觉为S0～S1。结论：内踝上岛状皮瓣适用于内、外踝部，足背近侧等与皮瓣供区较近的部位，皮肤软组织缺损面积相对较小的创面修复，对有踝关节动脉网严重损伤时需谨慎选择应用。

Medial supramalleolar island flap for repairing skin and soft tissue defect around foot and ankle

Objective To explore the restorative procedure and therapeutic effect of medial supramalleolar island flap on skin and soft tissue defect of foot and ankle. Methods Sixteen patients with skin and soft tissue defect of foot and ankle with exposure of Achilles tendon or malleolus after trauma or infection were treated with medial supramalleolar island flap. The maximal size of skin and soft tissue defect was 7 cm×10 cm. Results Fifteen flaps survived completely after operation, and one flap developed an epidermal necrosis over the distal part and underwent additional dermoplasty. All cases were followed up for 1 to 12 months. The skin texture and thickness of flaps were close to those of foot and ankle area. The sensation of the flaps was from S0 to S1. Conclusion Medial supramalleolar island flap is suitable for repairing the skin and soft tissue defects of a smaller area over foot and ankle without serious destruction of the malleolar arterial rete.