摘要
目的探讨腓肠神经营养血管皮瓣游离移植的手术方法及临床应用效果。方法切取由腓动脉发出单一皮穿支腓肠神经营养血管皮瓣，游离移植修复手背及涉及足前部的足踝部皮肤软组织缺损。皮瓣穿支动脉、小隐静脉分别与受区邻近的主干动脉分支及头静脉或大隐静脉吻合建立血液循环；亦可单纯吻合穿支动、静脉供血。皮瓣腓肠神经与受区皮神经吻合。结果2005年1月至2007年12月，于临床应用12例。皮瓣切取面积12cm×7cm～18cm×11cm，皮瓣全部成活。术后随访7～27个月，皮瓣外观、质地优良，两点辨别觉7～12mm，肢体功能恢复满意。结论本术式综合了游离皮瓣、穿支皮瓣与皮神经营养血管皮瓣的优点，皮瓣设计灵活，切取方便，修复位置随意，血供可靠，是修复手足皮肤软组织缺损的较好方法。
Objective To report the operative techniques and clinical results of the free peroneal artery perforator sural flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomosed with a branch of a nearby artery, and the small saphenous vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap＇s circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 cm × 7 cm to 18 cm ×11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 - 12 mm. Conclusions The flap has all the advantages of the free flap, the perforator flap and the flap. It is easily performed with reliable blood supply. It＇s a good choice for repairing the skin defects of hands and feet.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2009年第4期262-265,共4页
Chinese Journal of Plastic Surgery
