摘要
目的观察应用下肢两条皮神经营养血管皮瓣修复小腿远端和足踝部组织缺损创面的临床疗效。方法小腿远端及足踝部创面根据转移角度及距离灵活选择隐神经或腓肠神经营养血管皮瓣转移修复,术前先行多普勒检查明确穿支所在位置,根据神经走行设定皮瓣轴线,于深筋膜深面分离形成皮瓣,将隐神经或腓肠神经及伴行血管网包含于皮瓣内,转移修复创面,供区直接缝合或取皮植皮修复。结果 3年共应用该皮瓣修复下肢下段及足踝部缺损38例,完全成活33例,其余5例存在不同程度皮瓣远端坏死,2例经换药自愈,3例经清创植皮修复。结论隐神经及腓肠神经营养血管逆行皮瓣血供确切,解剖简单,完全能胜任小腿远端和足踝部组织缺损修复需要,适合基层医院开展。
Objective To observe the clinical efficacy of application of two kind of cutaneous nerve nutrient vessels flap of lower extremity in repair of tissue defects in distal leg and ankle. Methods The wounds in the distal leg and ankle were repaired by flexibly choosing the saphenous nerve or the sural nerve nutrient vessels flaps accord- ing to the angle and distance of the transferring. The preoperative Doppler was using for clearing perforating branch location. The flap axis was set according to the nerve walking line. The flap was separated at tile deep side of the deep fascia. The saphenous nerve or the sural nerve and their accompanying vascular nework were included in the flaps. Then the flap was transferred for wound repair. The donor site directly closed, or repaired by skin graft. Results In more than three years, these flaps were used for repairing the defects in the lower limbs and foot and ankle defects in 38 patients. The flaps in 33 patients survived completely, in the remaining five patients, there was varying degrees of distal necrosis. Of them, two patients were cured by dressing, three patients were cured by debridement and skin grafting. Conclusion Saphenous nerve and the sural nerve nutrient vessels retrograde skin flap have the advantages of precise blood supply, simple anatomy, and is able to meet the needs of repair of tissue defects in the distal leg and ankle and is suitable for application in the primary hospital.
出处
《中国临床新医学》
2012年第8期736-738,共3页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
皮瓣
隐神经
腓肠神经
Flap
Saphenous nerve
Sural nerve
