带腓血管的小腿外侧逆行岛状皮瓣的显微解剖学研究及临床应用.docVIP

带腓血管的小腿外侧逆行岛状皮瓣的显微解剖研究及临床应用 杨成林 毕郑钢 曹阳 付春江 韩昕光 [摘要] 目的　研究并探讨带腓血管的小腿外侧逆行岛状皮瓣血供的的血供显微解剖关系、临床应用及其疗效。方法　2000年～2005年，在对腓血管跨区关系进行显微解剖学研究的基础上，应用带腓血管的小腿外侧逆行岛状皮瓣治疗足踝部软组织缺损26例，皮肤缺损最大为22ｃｍ×11ｃｍ，最小5ｃｍ×8ｃｍ，切取皮瓣最大26ｃｍ×14ｃｍ。　结果　腓血管在外踝区发出穿动脉与胫前、外踝后血管及胫后血管相交通，形成侧支吻合动脉网；术后皮瓣均完全成活, 术后的外形平整美观，疗效好。结论 带腓血管的小腿外侧逆行岛状皮瓣侧支血供丰富，可以充分修复足踝部软组织缺损。 [关键词] 皮瓣；　软组织缺损； 腓血管； 显微外科 THE APPLICATION OF ECTOCNEMIAL REVERSE FLOW ISLAND FLAP ON THE PURE SOFT TISSUE DEFECTS OF FOOT AND ANKLE / YANG CHENGLIN , BI ZHENGGANG,，CAO YANG , et al. Department of Orthopaedics, the first Affiliated Hopital of Harbin Medical University, Harbin 150001,China. [Abstract] Objetive To study and investigate the blood supplying microanatomical relations and the application of ectocnemial reverse flow island flap with fibula vessels on the soft tissue defect of foot and ankle. Methods From 2000 to 2005, after studying the cross boundary relation of fibula vessels by using microanatomical technique, 26 cases of soft tissue defect on foot and ankle were repaired by using ectocnemial reverse flow island flap with fibula vessels, of　the　areas　from to 22cm×11cm，the most donor flap was . Results 2 major cross vessels are founded, of which one is the perforating artery communicating with anterior tibial artery, another is posterior lateral malleolus vessel communicating with posterior tibial artery. And postoperatively, all flaps survived with beautiful appearance. The curative effect was wonderful. Conclusions Ectocnemial reverse flow island flap with fibula vessels own enough blood supply by side vessels, so which can repair the soft tissue defect of foot and ankle reliably and effectively. [Key words] flap； soft tissue defect； fibula vessels；microsurgery 小腿以远足踝部严重创伤常导致较大面积皮肤软组织缺损，以致神经、血管、肌腱、骨骼等深部组织外露，并经常继发临床难以治愈的感染创面，对于这些复杂的病例，传统游离植皮、局部转位皮瓣治疗难以凑效，而交腿皮瓣又有其故有缺点。我们在对腓血管跨区关系进行显微解剖研究的基础上，于2000年7月～2005年7月，应用带腓血管的小腿外侧逆行岛状皮瓣治疗足踝部软组织缺损26例，获得良好的疗效。 资料与方法 一、腓血管外踝部跨区关系的显微解剖 作者单位：