腓肠肌瓣在腘血管损伤并大面积皮肤撕脱伤中的应用

目的:探讨胭动静脉损伤并同侧下肢大面积皮肤撕脱伤的治疗方法。方法:对6例胭动静脉损伤并下肢大面积皮肤撕脱伤者,在修复血管后用以腓肠内或外侧血管为蒂的腓肠肌瓣逆向旋转覆盖外露的腘动静脉,再行游离植皮修复创面。结果:6例经上述方法处理后均得以保肢。随访0.6-3.2年,患者能正常行走,上下楼梯无影响,患踝跖屈肌力无明显下降,膝关节伸0°,过伸5-10°,屈曲可达90-110°,患者对治疗满意。结论:利用腓肠内(外)侧血管为蒂的旋转腓肠肌瓣覆盖损伤外露的胭动静脉联合游离植皮修复创面是处理胭动静脉损伤并下肢大面积皮肤撕脱伤的一种简单、省时、实用的治疗方法,适合急诊处理,可获得良好的功能恢复。

The Application of Gastrocnemius Flap in Dealing with Injury of Popliteal Vessels Combined with Avulsed Wound of a Large Area Cutis in Lower Limb

Objective:To investigate a method for dealing with the injury of popliteal vessels combined with avulsed wound of a large area cutis in lower limb. Methods: In the course of treatment of patients with injury of popliteal vessels combined with avulsed wound of a large area cutis in lower limb,We used the method of covering the exposed popliteal vessels with the back rotated gastrocnemius flap, which pedicel is internal or external sural vessels, then cover the wound surface with free skingrafting. Results: Treated by the above-mentioned method, all limbs of this group of patients (6 cases) have been saved. Following up (0. 6-3. 2 years) showed the patients can walk normally in daily life. Conclusion: For emergency treatment with injury of popliteal vessels combined with avulsed wound of a large area cutis in lower limb,it s a simple,practical and timesaving method to cover the naked popliteal vessels with the back-rotated gastrocnemius flap and cover with free skingrafting sequentially. A good functional restoration can be achieved.