腓肠浅动脉逆行岛状筋膜皮瓣急诊修复下肢创伤性皮肤软组织缺损

目的探讨急诊一期修复小腿中下段及足部创伤性软组织缺损的方法. 方法 2000年2月～2003年12月,应用同侧腓肠浅动脉逆行岛状筋膜皮瓣急诊一期修复小腿及足部皮肤软组织缺损18例,并分析其可行性及手术注意点;切取皮瓣4 cm×5 cm～11 cm×12 cm. 结果除2例皮瓣远端1/3发绀并坏死经换药Ⅱ期愈合外,其余皮瓣均Ⅰ期愈合.随访1～2年,有2例皮瓣臃肿,其余外观满意,功能均恢复正常. 结论腓肠浅动脉逆行岛状筋膜皮瓣急诊修复创伤性皮肤软组织缺损,具有早期闭合创面、促进早期功能锻炼的优点,尤其适合于急诊修复小腿下1/3及其足踝部的皮肤软组织缺损.

EMERGENCY REPAIR OF SKIN AND SOFT TISSUE DEFECTS OF LOWER LIMBS WITH ISLAND FASCIOCUTANEOUS FLAP SUPPLIED BY SUPERFICIAL SURAL ARTERY

OBJECTIVE: To find a better method of emergency repair of skin and soft tissue defects in the lower leg, ankle and foot. METHODS: The distally based superficial sural artery flap was designed on the posterior aspect of the leg. From February 2000 to December 2003, 18 patients with skin and soft tissue detects of the lower leg, ankle and foot were treated with island fasciocutaneous flap supplied by superficial sural artery by emergency. The size of the flap ranged form 4 cm x 5 cm to 11 cm x 12 cm. RESULTS: The flaps survived totally in 16 cases and necrosed partially in 2 cases. After 1-2 year postoperative follow-up, the results were satisfactory except that in 2 flaps. CONCLUSION: The island fasciocutaneous flap supplied by superficial sural artery may provide a useful method for emergency repair of soft tissue defect of the lower limbs.