腓肠神经营养血管蒂皮瓣交腿修复胫前及足部软组织缺损临床医学.docVIP

腓肠神经营养血管蒂皮瓣交腿修复胫前及足部软组织缺损临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：腓肠神经营养血管蒂皮瓣交腿修复胫前及足部软组织缺损临床医学 2 1 一般资料 3 2 手术方法 3 1 腓肠神经营养血管皮瓣的优缺点 4 2 手术注意事项 5 文2：腓肠神经营养血管蒂岛状皮瓣修复足跟部软组织缺损18例临床医学 5 1 临床资料 5 11 一般资料 5 12 方法与结果 6 1 皮瓣设计 6 1 皮瓣的切取 6 1 皮瓣的转移 6 1 术后处理 6 2 讨论 7 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 10 正文 腓肠神经营养血管蒂皮瓣交腿修复胫前及足部软组织缺损临床医学 文1：腓肠神经营养血管蒂皮瓣交腿修复胫前及足部软组织缺损临床医学 Abstract: Objective To explore the effect of cross-leg repair for the anterior tibial and foot soft tissue defects with sural neurovascular From to ,there were 11 cases of anterior tibial and foot injury with infection,necrosis of soft tissue defect and bone debridement, the sural nerve nutrition blood vessels were used to size of anterior tibial soft tissue defect ranged: ××; the size of foot soft tissue defect:××;flapcut:×× longest length of pedicle was After operation, 10 cases healed in stageⅠ,1 case in stage Ⅱ.Followup ranged from 3 months to 3 yea with good texture and necrosis was found in 1 case;crossleg pressure sore in 1 elderly patients;pinprick infection in 2 has small effect on knee and ankle joint function and only a small portion of flaps recovered in Crossleg repair for the anterior tibial and foot soft tissue defects with sural nerve nutrition blood vessel is an effective time fixation, which easily leads to joint stiffness in elderly patients,should be used with sore should also be prevented. Key words:injury repair;flap;foot;lower limbs;soft tissue defect 严重的胫前及足部软组织缺损常伴有骨外露，需要皮瓣修复。笔者自2004年1月～2007年12月，采用腓肠神经营养血管蒂皮瓣交腿修复胫前及足部软组织缺损11例，疗效满意，现报告如下。 临床资料 1 一般资料 本组11例病例，男性8例，女性3例;年龄10～68岁，平均岁。外伤创面感染坏死骨外露9例(2例钢板螺钉外露)，慢性骨髓炎坏死骨外露2例。11例中胫前7例，胫前软组织缺损×～×;足部4例中，足背2例，足底、足跟各1例，均有肌腱外露，软组织缺损×～×。9例为同侧损伤面积过大，2例经多次取皮术后失败，致使同侧不能获取合适的皮瓣修复。皮瓣范围为×～×。 2 手术方法 麻醉后常规消毒铺巾，彻底清除坏死组织及失活的骨组织，修剪伤口边缘瘢痕。术前胫腓骨骨折外固定支架固定2例，钢板固定3例，2例创面附近找出表浅神经待吻合。皮瓣切取均为逆行皮瓣，根据缺损的形状及面积在对侧的小腿设计皮瓣，以外踝和跟腱之间中点与腘窝中点连线为皮瓣的轴心线，以外踝上5～7cm处为旋转点，沿轴心线两侧2～4cm分别切开皮肤深达深筋膜，找出腓肠神经，向近端分离切断，使其超出皮