游离腓动脉穿支动脉皮瓣修复前足皮肤缺损.pdfVIP

游离腓动脉穿支动脉皮瓣修复前足皮肤缺损 雷林革∗，何如祥，沈美华，张建磊，祁多宝 （解放军第一医院手足外科，甘肃，兰州） 【摘要】 目的：探讨应用游离腓动脉穿支动脉皮瓣修复前足软组织缺损的方法和临 床效果。方法 对 11 例前足皮肤缺损应用游离腓动脉肌皮穿支动脉动脉皮瓣修复。切取面积 从 2.5cm×4.5 cm～4.0 cm×9 cm。动脉血管蒂与受区采用端侧吻合或端端吻合。结果 术 后皮瓣全部成活。随访 6～24 月，皮瓣略臃肿，外观及弹性良好，功能较好，皮瓣供区组织 损伤轻，较小的缺损，供区可直接缝合，即便植皮，瘢痕较小且隐蔽。结论 腓动脉穿支动 脉动脉皮瓣的血管解剖恒定、皮瓣厚薄适中，操作简单，是修复前足软组织中小面积缺损的 有效方法。 『关键词 1 腓动脉；穿支动脉动脉皮瓣；前足；软组织缺损 Free flap with perforator of peroneal artery to repair the forefoot skin defects Lei Lin-ge, He Ru-xiang, Shen Mei-hua, Zhang Jian-lei,Qi Duo-bao (HandFoot Surgery, First Hospital of PLA, lanzhou Gansu,730030 china) [Abstract] Objective: To explore the surgical technique and clinical outcome of applying the free flap nourished by perforator of peroneal artery to repair skin defects of the forefoot．Methods:Totally 11 forefoot skin defects with the size from 2.5 cm×4.5 cm～4.0 cm×9 cm ,were involved in free perforator flap from peroneal artery．In most cases the blood vessels were anastomosed either end-to-end or end-to-side．Results : All the transferred free flaps survived uneventfully．Followed up for 6 to 24 months，the outlooks as well as ,flexibility were satisfied, It is better of the function and the light tissue damage of the donor site．the smaller donor site can seam intimate，even if it need skingrafting，the cicatricle is small and concealment. Conclusions : The perforators of peroneal artery had a relatively invariable anatomy，easier to handling．So it was useful to repair small1 and middle areas of skin defects in forefoot． [Key words】peroneal artery； perforator flap；forefoot； soft tissue defect 1985 年由顾玉东首先报道小腿外侧以腓动脉皮支为血管蒂的皮瓣，这些皮支多数穿过小 腿三头肌或小腿外侧肌间隙至浅层供养皮肤，皮瓣切取后对小腿的血供影响较小，既可吻合 血管游离皮瓣移植，也可顺行或逆行转移，皮瓣切取范围灵活。2007年 6 月-2011年 6 月我 们采取游离腓动脉穿支血管蒂皮瓣移植修复前足皮肤缺损，效果良好，探究其临床应用。 1 资料和方法 1.1 一般资料：本组 11 例，男 10 例，女 1 例，年龄 23～46 岁。车祸伤 4 例，压砸伤 3 例，机器绞伤 1 例，缺损面积为 2.0 cm×4 cm～3.5 cm×8.5 cm 大小，缺损部位：采取 急症或亚急诊腓动脉穿支顺行