腓肠肌内侧头岛状肌瓣修复胫骨上端感染创面

目的：总结腓肠肌内侧头岛状肌瓣修复胫骨上端感染创面的临床应用结果。方法：胫骨上端感染创面9例,男7例,女2例;年龄21～60岁,平均34岁。应用改进的腓肠肌内侧头岛状肌瓣修复,供区均选用同侧小腿。肌瓣表面行Ⅰ期中厚网状游离植皮,供区直接缝合。结果：仅1例术后发生表浅感染,经换敷料逐渐愈合。所有患者肌瓣和其上植皮全部成活。术后随访13个月～4年,平均21个月,供区愈合良好,未发现明显功能障碍。结论：腓肠肌内侧头岛状肌瓣以腓肠内侧动脉为血供,具有血供丰富,血管解剖恒定,血管蒂长,以及肌瓣较薄的优点,带蒂移植适宜修复胫骨上端软组织缺损。

The sural medial gastrocnemius island muscle flap to cover wound of infection on upper region of the tibial

Objective: To summarize clinical application of the sural medial gastrocnemius island muscle flap to cover wound of infection on upper region of the tibial. Methods: Nine patients(7 men,2 women)with soft tissue defects on the upper region of the tibial underwent reconstruction with the sural medial gastrocnemius island muscle flap. The age ranged from 21 to 60 years old(mean,34 years). The immediate coverage of the muscle flaps were performed by a meshed split-thickness skin graft. The donor site was closed directly. The donor leg was ipsilateral in all cases. Results: Only one case sustained superficial infection postoperative and the gradual wound healed by daily wound dressings. All the muscle flaps and skin graft had survived completely without major complication with satisfactory clinical results. All patients were followed-up for 13 months to 4 years(mean 21 months),the donor site was healing,there was no remarkable donor site morbidity. Conclusion: The sural medial gastrocnemius island muscle flap is nourished by the medial sural artery. The muscle flaps seem to have highly vascularize,a constant vascular anatomy and a long vascular pedicle. The muscle flap is thin and suitable for repairing soft tissue defect on the upper region of the tibial.