以踝部吻合支供血的胫前动脉逆行岛状皮瓣的临床应用

目的探讨为足背部皮肤及软组织缺损进行修复提供一种新型血供来源的皮瓣。方法根据下肢胫前动脉及足背动脉的行径、分支、分布及其与胫后动脉、腓动脉分支的吻合情况，设计以踝部吻合支供血的胫前动脉逆行岛状皮瓣，临床应用修复足背皮肤及软组织缺损11例，皮瓣面积最大13cm×9cm，最小8cm×6cm。结果胫前动脉及足背动脉在踝部的4个分支（外踝前动脉、内踝前动脉、跗外侧动脉、跗内侧动脉）经与腓动脉及胫后动脉的分支吻合，可以满足胫前动脉逆行岛状皮瓣的供血需要。临床应用中，10例皮瓣全部存活，1例皮瓣有远侧小部分坏死，经换药及游离植皮后创面愈合。结论以踝部吻合支供血的胫前动脉逆行岛状皮瓣转移可用于修复足背部的皮肤及软组织缺损。

Clinical application of the retrog rade a nterior tibial ery island flap suppli ed by the anastomotic ranchesaround ma lleolus

Objective To provide a flap with a new kind of blood supply for repairing the skin and soft tissue defects of the dorsum pedis. Methods The course， branches， distribution and anastomosis of the anterior tibial artery and the do rsal pedal artery were reviewed. The retrogr age anterior tibial artery island flap whose blood was supplied by the anastomos is branches around the malleolar regions were designed and applied in clinical to repair the skin and soft tissue defect at the dorsal pedal regions of 11 patients. The size of flap ranged from 8 cm× 6 cm～13 cm×9 cm. Results The ant erior tibial artery and dorsal pedal artery have four branches （lateral anterior malleolar artery， medial anterior mall eolar artery， lateral tarsal artery and medial tarsal artery）， which ana stomosis with the branches of posterior tibial artery or peroneal artery at the malleolar regions， can sufficiently provide the blood supply for the retrograde anterior tibial artery island flap. The flaps totally survived in 10 cases， the other has a distal necrosis with 1.5 cm× 3.0 cm. Conclusions The retrogra de anterior tibial artery island flap supplied by the anastomosis branches around malleolus can be used in repairing skin and soft tissue defect at the dorsal pedal re gions.