游离腓骨瓣皮岛的血供来源及其可靠性探讨

目的　探讨游离腓骨瓣皮岛的血供来源及其可靠性。方法　对 1999年 6月至 2 0 0 2年 3月所完成的178例游离腓骨瓣作回顾性分析 ,分析腓骨瓣所携带皮岛穿支血管的类型及皮岛的成活情况。结果　 178例游离腓骨瓣中 ,3例因术中未发现明确的皮肤穿支血管而未制备皮岛 ,其余的 175例术中均发现有明确的穿支血管 ,除3例为肌皮穿支外 ,其余均为隔皮穿支。 2例患者因术中损伤穿支血管而放弃皮岛 ,其余 173例均完成皮岛的制备和转移 ,其中 8例为双皮岛转移 ,皮岛最大面积 2 2cm× 8cm ,最小 2cm× 1cm。 178例腓骨瓣中 ,2例因术后腓静脉栓塞而将皮岛连同腓骨瓣一起去除 ,其余的 176例腓骨瓣的 179块皮岛均获得 10 0 %的成活。结论　绝大多数患者的游离腓骨瓣均可制备有明确穿支血管供应的皮岛 ,且绝大多数的穿支血管为隔皮穿支。只要有明确的穿支血管 ,游离腓骨瓣皮岛的血供十分可靠。

The reliability of blood supply of skin paddles of free fibula flaps

Objective To analyse the reliability of blood supply of skin paddles of free fibula flap.Methods One hundred and seventy-eight consecutive free fibula flap transfers performed from June of 1999 to March of 2002 were reviewed.The skin paddles of each flap were analyzed in terms of surgical design,size,type of perforators,and clinical survival.Results Of the 178 fibula flaps,3 were found without distinct skin perforators during surgery, and the other 175 were found to have either septocutaneous perforators (172/175) or musculocutaneous perforators (3/175).The skin paddles of two fibula flap were abandoned during the operation because of the injury of septocutaneous perforators,and the other flaps were successfully elevated with skin paddles.Apart from two failed fibula flaps because of thrombosis of peroneal vein,other flaps were survived with 100% survival rate of 179 skin paddles.Conclusion Skin paddles of fibula flap were very reliable only if they had distinct skin perforators, and most of the perforators were septocutaneous perforators, with very few were musculocutaneous perforators.