皮神经营养血管逆行岛状皮瓣修复肢体远端组织缺损

目的分析皮神经营养血管逆行岛状皮瓣修复肢体远端组织缺损的适用性。方法应用皮神经营养血管逆行岛状皮瓣修复30例患者肢体远端组织缺损，其中前臂外侧皮神经营养血管带蒂移植5例，腓肠神经营养血管带蒂移植11例，隐神经营养血管带蒂移植14例。所有被修复创面均有不同程度的血管、神经、肌腱或（和）骨质外露。结果1例患儿术后因蒂部受压致皮瓣远端部分坏死，经换药治愈；1例患者因术后感染，皮瓣周边成活不良，经肉芽植皮术后治愈；其余28例患者所植皮瓣全部成活，血运良好，修复部位外观及功能恢复较为满意。结论皮神经营养血管逆行岛状皮瓣解剖结构恒定，血供可靠，手术操作简单，不损伤主要血管及肌肉组织，适用于肢体远端组织缺损的修复。

Application of reverse island flaps pedicled with cutaneous nerve nutrient vessels to repair defect on distal parts of extremities

Objeetive To analyze the feasibility of reverse island flaps pedieled with cutaneous nerve nutrient vessels in repairing the defect on distal parts of extremities. Methods Thirty patients with tissue defect in distal extremities, complicated by exposed vessels, nerve, tendons, and/or bones ,were repaired with island flaps pedieled with neuroeutaneous nutrient vessel. Among them, five cases were grafted with flaps with external forearm cutaneous nerve vessels, eleven eases were grafted with flap containing sural neu ral nutrient vessels in its pedieale,and 14 cases with saphenous nerve nutrient vessels in the pedieles. Resuits The flaps of 28 cases survived with perfect appearance and function. In one case partial necrosis occurred because of compression on the pediele, but the patient healed after dressing, and another case with necrosis of the edge of the flap due to infection, but also healed after skin grafting. Conclusion The reverse island flaps pedieled with cutaneous nerve nutrient vessels which are constant in anatomy, with reliable blood supply, can be recommended because its simple operative technique, non-injurious to main blood vessels and muscles, the repair of distal defects of the extremities.