腓肠神经营养血管皮瓣修复儿童足踝部皮肤组织缺损.docVIP

腓肠神经营养血管皮瓣修复儿童足踝部皮肤组织缺损[摘要]目的：总结探讨临床运用腓肠神经营养血管皮瓣修复儿童足踝部皮肤组织缺损的疗效。方法：对10例儿童足踝部皮肤组织缺损的病例，采用带腓肠神经营养血管蒂逆行岛状筋膜皮瓣修复。皮瓣面积最大11cm×8cm，最小6cm×4cm。结果：10例皮瓣全部存活，达到皮肤组织缺损修复及骨骼、肌腱良好覆盖的效果。随访3个月～2年，平均1年，皮瓣质地优良，皮瓣外观及踝关节功能均满意。结论：该皮瓣血运可靠，手术操作及设计简便，不损伤小腿的主要血管，可理想修复儿童足踝部皮肤软组织缺损。 [关键词]腓肠神经；营养血管皮瓣；皮肤组织缺损；修复；足踝 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）03-03 Skin flap with sural nerve vasa vasorum for repairing defect of skin and soft tissues of ankle area in children XIONG Bing-gang, XIE Wen-wei, YAO Han-gang, LI Sheng-cheng, LIAO De-yun，LI Zai-xue, LI Ming-hua, SU Chang-yao （Department of Orthopaedics,Shilong People`s Hospital of Dongguan City, Dongguan 523321,Guangdong，China） Abstract:Objective To investigate the clinical application of the skin flap with sural nerve vasa vasorum for repairing defect of skin and soft tissues of ankle areain children.MethodsWe repaired the soft tissue defect by the skin flap with sural nerve vasa vasorum, 10 children patients associated with cutaneous injury and soft tissue defect of ankle were cured. The sizes of the flaps used ranged from 11cm×8cm to 6cm×4cm.ResultsAll the cases were totally survival. All soft tissue defects were repaired and their accompanied bone and tendon exposure healed. With follow-up from 3~24months in all cases, the skin quality, colour, ankle function and appearence were satisfactory. ConclusionThis flap is ideal for repairing defect of skin and soft tissues of ankle area in children, for it had reliable blood supply, convenient in design and no damage to the major arteries. Key words: sural nerve；nutrient vessel flaps；soft tissue defect；repair；ankle 足踝部皮肤组织缺损在骨科临床中经常遇到。因局部软组织少，损伤后容易导致皮肤软组织缺损，且常伴有骨骼、肌腱外露及感染。由于该处皮肤质地厚韧、不易滑动、局部可供转移覆盖创面皮肤组织有限，修复相当困难。自1999年起我们运用腓肠神经营养血管皮瓣修复成人小腿下1/3及足踝部皮肤组织缺损，取得满意疗效。但对于儿童类似病例，我们治疗则较保守，考虑到儿童创面愈合自身修复能力强，一般经换药至创面有肉芽生长再采用游离植皮修复。这样虽然可以达到消灭创面目的，但疗程长，愈后往往是不稳定的贴骨瘢痕，影响儿童生活质量。所以我们考虑运用此类皮瓣于儿童足踝部创面修复。自2002年3月～2007年8月共收治儿童足踝部皮肤组织缺损患者10例，均采用带腓肠神经营养血管蒂逆行岛状筋膜皮瓣予以修复，疗效满意。 1资料和方法 1.1 一般资料：