跖内侧皮瓣切取方法的改进及应用

目的研究跖内侧动脉向足内侧区发出皮支的分布情况，改进皮瓣切取方法。方法通过８例成人新鲜足标本的显微解剖，灌注美蓝，测定跖内侧动脉所供应的皮区范围。结果跖内侧动脉向足内侧区恒定发出三个皮支，以第２支较粗并与第１、３支相吻合。临床以该支为蒂设计皮瓣局部转移修复足部创面７例，游离移植修复手指创面６例，范围为３ｃｍ×３ｃｍ～１１ｃｍ×７ｃｍ，术后皮瓣全部成活，效果满意。结论该皮瓣质地优良，面积适中，血供可靠，是修复足部与手指中、小面积皮肤缺损的最佳选择之一。

IMPROVED METHOD OF OBTAINING MEDIAL PLANTAR CUTANEOUS GRAFT AND ITS CLINICAL APPLICATION

Objective To introduce a skin flap containing the middle cutaneous branch of the medial plantar artery. Methods Microanatomic study was performed on 8 fresh cadaverie feet, the arteries were dissected and infused with methylen blue to observe their vascular distribution and the skin area supplied by the middle cutaneous branch. Furthermore, the clinical application was reported. A local pedicled flap containing the middle cutaneous branch was used to repair the soft tissue defects of the foot in 7 patients, and free cutaneous graft was used to repair the skin defects of the fingers in 6 patients. Results The results showed that the medial plantar artery gave off 3 cutaneous branches to supply the medial aspect of the foot, among which the middle branch was the largest one and anastomosed with the other two branches. The skin flaps used clinically were all survived completely. Conclusion Medial plantar cutaneous graft had a reliable blood supply, and it's one of the best choice in repairing small to middle sized skin defects of the foot and the fingers.