腓肠神经营养血管逆行岛状皮瓣临床应用.docVIP

腓肠神经营养血管逆行岛状皮瓣临床应用[摘要]目的：初步总结腓肠神经营养血管逆行岛状皮瓣在修复小腿中下段及足部创面的临床效果。方法：2006年1月～12月，我科采用腓肠神经营养血管逆行岛状皮瓣共10例，皮瓣最大面积为18cm×13cm，最小为4.5cm×10cm；其中男9例，女1例。其中骨髓炎骨外露6例，肌腱外露4例。供区直接缝合或植中厚皮片。结果：术后皮瓣完全成活，个别病例术后较臃肿，待二期将皮瓣修薄。结论：应用腓肠神经营养血管逆行岛状皮瓣修复小腿中下段及足部创面的临床效果可靠，手术操作简便，不牺牲小腿主要血管神经，对足部影响较小，便于推广开展。 [关键词]腓肠神经营养血管；岛状皮瓣 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）05-02 The clinical application ofantidromic island flap providing blood supply by suralis nerver LI Zhao-yang,SONG Zhao-hui,GUO Zhi-long,YU Ping,ZENG Xue-wen,CHEN Hui-lin,WU Jun-jiang （1. Department of Plastic Surgery, the People′s Hospital l of Xinjiang Uighur Autonomous Region,Urumchi 830001,Xinjiang, China; 2.Fukang People’s Hospital） Abstract:ObjectiveTo summarize the clinical effect of repairing soft tissue defects in lower part of shank, the foot, with antidromic island flap providing blood supply by suralis nerver.MethodsFrom January to December 2006,there were 10 cases repairing soft tissue defects with antidromic island flap providing blood supply by suralis nerver, including 9 males and 1 females. The biggest area was 18cm×13cm,and the smallest was 4.5cm×10cm.There were 6 cases osteomyelitis with bone exposure,4 cases muscle tendonexposure.donor-area direct suture or plant skin.ResultsAll flaps survived,several cases flap were fat and clumsy and need make them thin in second intention.ConclusionThe clinical result of repairing soft tissue defects in lower part of shank, the foot, with antidromic island flap providing blood supply by suralis nerver is reliable.The operation is sinple, without sacrifice of major arteries, low infection to foot, convenient for application. Key words: providing blood supply by sural nerve;island flap 足部、小腿下方受伤后创面常伴有肌腱、骨、钢板外露，对于这些创面常用局部皮瓣、带知名血管的岛状皮瓣、游离皮瓣来修复。局部皮瓣有长宽比及局部条件的限制，知名血管的岛状皮瓣及游离皮瓣对于解剖技术要求较高，常需牺牲一条主要血管，如果以后另一条主要血管发生损伤等意外，可能会造成肢体的坏死，对于居住在寒冷地区的北方人此方法会对足部抗寒功能造成影响，易发生冻疮，因此不易开展推广。腓肠神经营养血管逆行岛状皮瓣由于血供可靠，对血管蒂的解剖要求相对简单，对下肢的影响非常小，近年来该皮瓣由于其解剖方便正在广泛使用。我科于2006年1月～12月应用此皮瓣修复小腿中下段及足背