腓肠神经营养血管筋膜皮瓣修复足部皮肤软组织缺损

目的：总结及探讨应用腓肠神经营养血管筋膜皮瓣修复足部皮肤软组织缺损的疗效与经验。方法2007年3月—2014年3月，应用腓肠神经营养血管筋膜皮瓣修复合并肌腱和（或）骨外露的足部皮肤与软组织缺损108例，皮瓣面积：8.0 cm＆#215;15.0 cm～16.0 cm＆#215;27.0 cm。供区直接缝合27例，其余采用游离植皮修复。结果108例皮瓣移植104例全部成活，4例皮瓣远端部分坏死，2例经扩创换药后直接愈合，2例经再次植皮修复创面愈合。经3～18个月随访，皮瓣质地柔软，弹性好，无因皮瓣导致的足部功能障碍。结论采用腓肠神经营养血管筋膜皮瓣修复足部皮肤软组织缺损，皮瓣成活率高，手术操作简单，不损伤主干血管，是恢复足部功能的有效方法。

Repairing of soft tissue defects of the foot with sural neurovascular fasciocutaneous flap

Objective To summary and discuss the curative effect and experience of repairing soft tissue defects of the foot by application of sural neurovascular fasciocutaneous flap. Methods From March 2007 to March 2014, skin and soft tissue defects combined tendon and （or） bone exposed on the foot were repaired by sural neurovascular fasciocutaneous flap in 108 cases. The size of flap was 8.0 cm ＆#215; 15.0 cm to 16.0 cm ＆#215; 27.0 cm. The donor sites were sutured directly in 27 cases, others were repaired by skin graft. Results 104 cases survived completely, distal of flap was necrosis in 4 cases, the wounds were healed by dressing changing in 2 cases, and by skin grafting in 2 cases. After 3～18 months of follow-up, the flaps showed soft texture and good elasticity. Conclusion It is a simple, high survival rate, no major vascular injury method that by using sural neurovascular fasciocutaneous flap to repair the soft tissue defects of the foot.