应用腓动脉穿支腓肠神经营养血管皮瓣修复小腿及足踝部创面

doi:10.13418/j.issn.1001-165x.2020.05.20

Abstract

Abstract: Objective　To evaluate the clinical efficacy of peroneal perforator-plus pedicled sural neurofasciocutaneous flap in the reconstruction of lower leg and ankle soft-tissue defects.　Methods　Clinical data were collected from January 2017 to January 2019. Total 15 cases were involved in this study, all including the lower leg and ankle soft-tissue defects and were treated with the peroneal perforator-plus pedicled sural neurofasciocutaneous flap. The patients involves 11 males and 4 females. Range of age was from 14 to 65 (average 39 years). There were 6 cases of lower leg wound and 9 cases of ankle wound. Repair of wounds was with peroneal perforator-plus pedicled sural neurofasciocutaneous flap. The size of the soft-tissue defects ranged from 9 cm×4 cm to 26 cm×5 cm. The donor area site was sutured directly. If the tension of donor site was large, the skin graft was done to the site. After surgery, patients were taken routine treatment manners of immobilized, intravenous antibiotic, antithrombotic, antivasospasm, antiinflammatory and keep flap site warming. The flap survival and the effect of the reparations of the skin and soft tissue defect were observed during follow- up period.　Results　The flap size ranged from 10 cm×5 cm to 27 cm×7 cm. The patients were followed up for 6 to 22 months, with a mean of 13 months. 14 cases of the flap survived, 1 case with the venous reflux, the distance portion of the flap suffered from necrosis and second time wound debridement done, and the skin graft applied, the repair site healed well. 9 cases of ankle and foot ulcers represented as ankle joint dorsiflexion and plantar flexion slightly limited. 2 cases of tibial open fracture were treated with external fixation, and non-union occurred and changed to internal plate fixation and fracture union. 2 cases affected flap extruded from the wound site and inconvenient for shoeing, and the flap transformed and improved.　Conclusions　The peroneal perforator-plus pedicled sural neurofasciocutaneous flap in the reconstruction of the lower leg and foot defect is a good surgical intervention.

Key words: Peroneal artery, 　Sural nerve, 　Surgical flaps, 　Soft tissue injury

CLC Number:

R687.2

LIU Wei, YANG Zhi, TANG Shi-ting, SHA Ke, TAN Zhen, Cheng Jian-wen, SHI Xiao-rong, ZHAO Jin-min. Peroneal perforator-plus pedicled sural neurofasciocutaneous flap for repairing lower leg and ankle soft-tissue defects[J]. Chinese Journal of Clinical Anatomy, 2020, 38(5): 593-596.

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Peroneal perforator-plus pedicled sural neurofasciocutaneous flap for repairing lower leg and ankle soft-tissue defects

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