中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (5): 577-580.doi: 10.13418/j.issn.1001-165x.2015.05.020

• 临床研究 • 上一篇    下一篇

腓肠神经逆行岛状皮瓣修复下肢远端软组织缺损

刘强1, 刘会仁2, 王岩2   

  1. 1.华北理工大学,  河北   唐山    063000; 2. 唐山市第二医院,  河北   唐山  063000
  • 收稿日期:2014-11-11 出版日期:2015-09-25 发布日期:2015-10-13
  • 通讯作者: 刘会仁,主任医师,硕士生导师,E-mail:ssklhr@163.com
  • 作者简介:刘强(1981-),男,河北唐山人,在读硕士,主治医师,研究方向:手外科,显微外科,E-mail:vven555@163.com
  • 基金资助:

    河北省医学适用技术跟踪项目(G2015079)

Sural nerve retrograde island flap to repair distal leg soft tissue defect

LIU Qiang1, LIU Hui-ren2,  WANG Yan2   

  1. 1. North China University of Science and Technology,Tangshan,Hebei 063000, China; 2.The Second Hospital of Tangshan,Tangshan,Hebei 063000,China
  • Received:2014-11-11 Online:2015-09-25 Published:2015-10-13

摘要:

目的 探讨腓肠神经逆行岛状皮瓣修复下肢远端皮肤软组织缺损的临床治疗效果。  方法 2009年11月~2014年6月,应用腓肠神经营养血管逆行岛状皮瓣修复下肢远端皮肤软组织缺损52例,男性41例, 女性11例。年龄最小5岁, 最大64岁,平均37.3岁。软组织缺损面积4.0 cm×4.5 cm~6.0 cm×12.0 cm,皮瓣切取面积4.5 cm×5.0 cm~7.0 cm×15.0 cm。受伤至手术时间为9~45d。利用已经损伤的腓肠神经切取皮瓣21例。52例皮瓣蒂部均未结扎小隐静脉。   结果 术后皮瓣无水肿、淤血、起水泡等静脉瘀滞表现,全部成活。伤口Ⅰ期愈合39例,3例出现皮瓣下轻度感染,经换药治疗控制。伤口无再破溃,皮瓣颜色正常,外形满意,皮瓣质地良好。随访8~24个月,平均9个月,皮瓣感觉恢复,无溃疡, 色泽好,功能良好。  结论 腓肠神经逆行岛状皮瓣是修复下肢远端软组织缺损的理想选择,并且无论腓肠神经损伤与否均可利用。

关键词: 岛状皮瓣, 腓肠神经, 修复, 下肢

Abstract:

Objective To explore the clinical rapeutic effects of the retrograde island flap based on the sural nerve nutrient vessels in repairing skin and soft tissue defects in the distant lower limbs. Methods 52 patients were treated with the sural nerve nutrient vessels skin flap Between November 2009 and Jun 2014. The involved cases included 41 males and 11 females, with an average of 37.3 years old (range, 5 to 64 years old).   The size of soft tissue defects varied from 4.0 cm×4.5 cm to 6.0 cm×12.0 cm. The size of flap varied from 4.5 cm×5.0 cm to 7.0 cm×15.0 cm. The interval between injury and operating time was 9~45 days. In 52 case, the small saphenous vein was ligated in the flap pedicle. Result No postoperative venous congestion such as edema, congestion, and blisters occurred. All flaps survived. The flaps completely survived in 39 cases and healing by first intention was achieved. 3 cases with flap under mild infection, after treatment of control. The appearance and functional results were satisfactory with following up for 8 to 24 months. The color and texture of the flaps were good. The appearance and the function were satisfactory. Conclusion Sural nerve nutrient vessels of the retrograde island flap is an ideal choice for repair distal leg soft tissue defect. Not the small saphenous vein ligation of flap pedicle division of flap survival had no effect.

Key words:  Island flap, Sural nerve, Repair, Lower limbs