游离腓肠内侧动脉穿支皮瓣在足背中小型缺损创面中的应用

目的探讨游离腓肠内侧动脉穿支皮瓣修复足背中小型缺损创面的临床效果。方法2017年1月至2020年6月蚌埠医学院第一附属医院应用游离腓肠内侧动脉穿支皮瓣修复足背创面14例，创面面积为4.0 cm×6.5 cm~6.0 cm×8.5 cm，皮瓣切取面积5.0 cm×7.0 cm~6.5 cm×9.5 cm。14例病人供区均给予直接皮内缝合。结果14例移植皮瓣全部成活，1例术后3 h出现静脉危象，急诊手术探查后危象解除，顺利成活。术后定期随访了所有病人，随访时间为6~12个月，平均8个月，皮瓣颜色与周围肤色接近，无臃肿，皮瓣质地柔软，病人正常穿鞋，行走及步态正常，供区小腿仅残留线性瘢痕，功能无影响。结论游离腓肠内侧动脉穿支皮瓣修复足背中小型缺损创面，安全可靠，创伤小，术后外形和功能良好，值得临床中推广应用。

Application of free medial sural artery perforator flap in the treatment of small and mediumsized defects in the dorsum of foot

Objective To investigate the clinical effect of free medial sural artery perforator flap in repairing small and medium de-fect wounds on the dorsal foot.Methods Fourteen patients with dorsal foot wound who were treated with free medial sural artery perfo-rator flap in the First Affiliated Hospital of Bengbu Medical College from January 2017 to June 2020 were selected. The wound area was 4.0 cm × 6.5 cm to 6.0 cm × 8.5 cm, and the flap cutting area was 5.0 cm × 7.0 cm to 6.5 cm × 9.5 cm. The donor sites of 14 pa-tients were directly sutured.Results All grafted flaps survived in 14 cases. Venous crisis occurred in 1 case 3 hours after operation.The crisis was relieved after emergency operation and survived smoothly. All patients were followed up for 6 to 12 months. The color of the flap was similar to that of the surrounding skin without bloating. The skin flap was soft. The patients wore shoes, walked and walked normally. There was only linear scar in the donor leg, and the function was not affected.Conclusions The free medial sural artery per-forator flap is safe and reliable for repairing small and medium-sized defects in the dorsum of foot. It has good appearance and function after operation, and is worthy of wide promotion in clinic.