腓肠神经营养血管皮瓣修复足踝部软组织缺损18 例

目的观察腓肠神经营养血管皮瓣逆行修复足踝部及小腿软组织缺损的效果。方法设计带筋蒂的腓肠神经营养血管的岛状皮瓣,逆行修复足踝部及小腿软组织缺损18例,同时观察皮瓣可切取的范围血供及静脉回流情况。结果18例全部成活,1例出现水疱,远端边缘坏死,经换药后愈合。6个月后全部得到了随访,皮瓣外形、血运良好,感觉较差。结论该皮瓣血运可靠,成活率高,手术操作及设计简便,不损伤小腿主要血管,是理想的修复足跟、内外踝、足跟腱区小腿下1/3软组织缺损的神经营养血管皮瓣。

Vascular flap with sural nerve for renovation of parenchyma defect in malleoli in 18 patients

Objective To observe the therapeutic effects of vascular flap with sural nerve for renovation of parenchyma defect in malleoli.Methods Eighteen patients with parenchyma defect in malleoli and legs were treated by prepared pedicle vascular island-flap with sural nerve,and the blood flow and venous return in resectionable scope were observed.Results All of 18 flaps were survival.Occurrence of blister on the flap and necrosis at flap's borderline were observed in 1 patient,and cured by change dressings.after 6 months,appearance and blood supply were good in all patients in following-up observation.Conclusion The vascular flap with sural nerve possesses well blood supply and higher survival rate,don't injury majior vascular of leg,so it particularly is sutable for reparation of soft tissue defect in distal 1/3 of leg.