小隐静脉-腓肠神经营养血管皮瓣的临床研究

目的　报道远端蒂及近端蒂小隐静脉 腓肠神经营养血管皮瓣修复下肢软组织缺损的效果。　方法　采用近端蒂及远端蒂、带腓肠神经或不带腓肠神经的小隐静脉 腓肠神经营养血管皮瓣 ,修复 2 5例小腿胫前近、中、远段和踝周、足背及足跟皮肤缺损 ,皮瓣最小面积为 5cm× 4cm ,最大面积为10cm× 15cm。　结果　 2 5例中远端蒂皮瓣 2 2例 ,近端蒂 3例 ,不带腓肠神经的皮瓣 3例 ,皮瓣全部成活 ,皮瓣质地优良 ,外观及功能满意。　结论　该皮瓣可行近、远端蒂转移 ,皮瓣可带或不带腓肠神经 ,均有足够的血运。本皮瓣成活率高 ,操作简便 ,不牺牲主干血管 ,是修复小腿胫前、踝周及足跟部软组织缺损的理想皮瓣。

Clinical study of distally and proximally based lesser saphenous-sural nerve vascular island flap

Objective To explore the clinical application of lesser saphenous-sural nerve vascular island flap to be transferred distally and proximally for the leg reconstruction. Methods The twenty five patients with soft tissue defects in the anterosupper part of the tibia,middle and distal one third of anterior tibia,around the ankle,foot dorsum and heel,were treated with proximally and distally based lesser saphenous-sural nerve vascular flap. Results The flaps survived in all 25 patients,including 19 cases with distal base,3 cases with proximal base,3 cases preservation of the sural nerve in the donor area.Their appearance and function were satisfaction. Conclusion This flap,which can be designed in proximal base or distal base,and including sural nerve or not,has sufficient blood supply.This flap has a high survival rate,the dissection is eassy,without sacrifice of major arteries.It can be used reliably for anterior tibial,ankle and heel reconstuuction.