隐动脉穿支蒂股神经前皮支营养血管逆行皮瓣的临床应用

目的 探讨隐动脉穿支蒂股神经前皮支营养血管逆行皮瓣的手术方法和临床应用效果.方法 对膝周或小腿上段软组织缺损,根据创面大小与形状,设计以隐动脉穿支为蒂沿股神经前皮支营养血管轴切取逆行皮瓣进行修复.2005年10月以来,于临床应用16例,皮瓣面积15 cm×7 cm～30 cm×15 cm,皮瓣旋转角度最大180°,最小100°.结果 13例皮瓣全部成活,3例皮瓣术后远端1/7～1/5坏死,经换药或局部皮瓣推进后愈合.随访6～24个月,皮瓣质地优良,外形与功能恢复良好,供区无明显不适.结论 该术式结合了穿支皮瓣与皮神经营养血管皮瓣的优点,扩大了股前内侧区皮神经营养血管皮瓣的切取范围,为下肢较大面积皮肤软组织缺损的修复提供了较好的方法.

Clinical application of the reverse neurocutaneous flap with anterior cutaneous branch of the femoral nerve supplied by the perforator of saphenous artery

Objective To report the operative technique and clinical application of the reverse neurocutaneous flap with anterior cutaneous branch of the femoral nerve supplied by the perforator of saphenous artery. Methods The reverse neurocutaneous flap with anterior cutaneous branch of the femoral nerve supplied by the perforator of saphenous artery was used for repairing the defect around knee or at the upper part of leg.Since Oct. 2005, 16 cases were treated. The flap size ranged from 15 cm×7 cm to 30 cm×15 cm. Flap rotation angle ranged from 100° to 180°. Results 13 flaps survived completely. Flap necrosis happened at the 1/7～1/5 distal end of the 3 flaps, which healed with dressing or local flap advancement. The patients were followed up for 6 to 24 months with satisfactory functional and cosmetic results. There was no morbidity at the donor site. Conclusion The flap has the advantages of both the perforator flap and the neurocutaneous flap. The size of the neurocutaneous flap with the anterior cutaneous branch of the femoral nerve can be enlarged for the large defect at lower extremity.