以股后皮神经营养血管为蒂的岛状皮瓣的临床应用

目的　探讨以股后皮神经营养血管为蒂的岛状皮瓣修复手术的应用。方法　采用以股后皮神经营养血管为蒂的岛状皮瓣修复臀部、窝及股内、外侧创面共 11例 12个创面 ,皮瓣最大面积 8 3cm× 16 6cm ,最小面积 4 0cm× 7 8cm。结果　 11例 12个创面中 ,9个创面皮瓣完全成活 ,创面一期愈合 ,3个因静脉回流障碍 ,皮瓣远端出现皮肤坏死 ,但皮下成活 ,经皮片移植后创面愈合 ,随访 8～ 19个月不等 ,皮瓣质地、外观及功能满意。结论　这一皮瓣的动脉血供可靠 ,不牺牲主干血管 ,解剖恒定 ,充分利用“浅静脉—皮神经营养血管系统” ,皮瓣蒂部保留“彗星尾”状皮肤组织是转移后皮瓣成活的重要保证。

Clinical applications of the postfemur island flap pedicled with the postfemur neurocutaneous nutrient vessel

OBJECTIVE: To investigate the application of the island flap based on the postfemur neurocutaneous nutrient vessel. METHODS: The flap was designed and applied to repair the defects in the gluteal, popliteal fossa or the bilateral postfemur areas. A total of 11 cases (12 defects) were treated with this method. The size of the defects ranged from 4.0 cm x 7.8 cm to 8.3 cm x 16.6 cm. RESULTS: Of the 12 defects, 9 achieved complete success. Epidermal necrosis occurred in the distal part of the flap in 3 defects owing to venous stasis, which were cured with skin grafting. Postoperative follow-up for 8-19 months showed that the appearance, texture, and function of the flap were satisfactory. CONCLUSIONS: The advantages of the flap lie in the reliable blood supply, constant anatomy, and without sacrificing a major artery. The key points for the flap survival are utilizing the "Superficial vein-nutrient vessel of the cutaneous nerve system" and retaining a comet tail-shaped soft-tissue pedicle in the flap creation.