摘要
作者用吻合血管的游离皮瓣移植及带血管蒂的岛状皮瓣移位,修复23例小腿下1/3和足部组织缺损,除1例皮缘部分坏死外,均获成功。作者强调了对炎性病灶,应彻底清除病变组织;对静脉曲张性溃疡应首先治疗静脉曲张,或在覆盖创面同时治疗静脉曲张;在采用吻合血管的游离皮瓣移植时,应在受区解剖出正常的大隐静脉和小隐静脉,在高位进行吻合。这些经验都是很成功的。 对小腿及踝、足创伤、炎症、肿瘤切除后的组织缺损,修复方法甚多,如小腿内侧上部皮瓣,小腿内侧下部皮瓣,胫前皮瓣,小腿外侧皮瓣,小腿顺行或逆行筋膜皮瓣,小腿后方皮瓣,足背皮瓣,足背外侧皮瓣,伸趾短肌皮瓣,足底内侧或外侧皮瓣,外展(足母)短肌皮瓣等10余种,可作带蒂移位,临床应用十分灵活。除非小腿、踝足局部条件太差,不能进行邻近的组织移位修复时,可选择吻合血管的远位组织移植修复。用前臂皮瓣修复小腿皮肤缺损并不是最佳选择,以选择肩胛皮瓣、股部皮瓣为好。
From 1984- 1988, 23 cases withmeanage 30 years old of soft tissuedefects at lower leg and foot wereperformed by axile skin flaps.The couses of defect were: chroniculcers in 14 cases;defect after resect-ion of tumors in 6; contructuredeformity of scar ih 2 and avalsionof skin in one. Transplantation freeskin flap were made in 9 casesby anastomosis of vessels includingChinese flap in 6 cases, medial legflap in 2 and scapular skin flap in one.Transfer of island skin flap withvascular pedicle were performed in14 cases, including dorsalis pedis flapin 9, island skin flap with posteriortibialis artery in 3, and mediaartery metatarseae plantares flap in 2.Square of skin flap were 18. 5 ×9-3. 5 ×3. 5cm. In 22 flaps were surv-ived and one feilure postoperation.In20 cases were followed from 4 mon-ths to 4 years. There was recurencein one case. The results were satis-factory.
出处
《修复重建外科杂志》
CSCD
1990年第1期7-8,共2页
Chinese Journal of Reparative and Reconstructive Surgery
