踝后双桥式皮瓣修复足跟软组织缺损

目的 修复足跟软组织缺损。方法 采用踝后双桥式皮瓣连续推进法共完成３７例。踝后双桥工皮瓣的蒂分别设计在内、外踝两侧,根据足跟创面,先设计下桥式皮瓣,其上缘呈弧形;然后再设计桥式皮瓣上缘为Ａ形。在深筋膜下游离皮瓣,慎勿损伤胫后神经血管束。结果：３７例术后除２例上桥皮瓣中间上部皮级部分坏死外,经换药治愈,余均全部成活,Ⅰ期修复,经１年以上随访移植皮瓣无一例发生溃疡。结论 该皮瓣外形厚薄适宜,血运、弹性

Repairing the soft tissue defect in the heel with a double-bridge pattern flap of the posterior ankle]

OBJECTIVE: This is to introduce a method for repairing the soft tissue defect in the heel. METHODS: The double-bridge pattern flap in the posterior ankle region was designed with the pedicles of the flap being in each side of the malleoli. According to the defect, the lower bridge-pattern flap with an arc-shaped upper margin was designed first. Then the upper bridge-pattern flap was designed with a "lambda"-shaped margin. The flap was raised with the deep fascia and advanced down to cover the defect. In dissecting the flap, care should be taken not to damage the posterior tibial nerve and blood vessel bundle. The flap was used in 37 patients. RESULTS: All the flaps survived except 2, in whom partial necrosis occurred in the upper bridge-pattern flap; they healed after dress changings. Follow-up of more than one year indicated that no ulcer took place in all the transferred flaps. CONCLUSION: The blood supply and elasticity of the flap are good. Its sensation and resistance to friction and shearing are satisfactory. Distinguishable distance of two points in the flaps was 13 to 14 mm.