【摘要】 目的探讨应用带小隐静脉-腓肠神经营养血管的筋膜瓣逆行转移修复足踝部软组织缺损的手术方法和临床效果。方法 2007年3月至2010年12月收治29例足踝部软组织缺损患者,在患肢小腿后外侧选择性切开,向远端游离筋膜瓣至外踝尖上约5cm并以此为旋转点,逆行转移筋膜瓣覆盖足踝软组织缺损区,术中切取筋膜瓣范围约为5cm×4cm～14cm×12cm,供区直接缝合,蒂根部及筋膜瓣表面游离植皮修复。结果随访5个月至3年,术后29例筋膜瓣全部成活,仅2例筋膜瓣远端局部回流障碍,浅表组织坏死,经抗感染治疗后愈合,供区Ⅰ期愈合,所有患者皮瓣外形及功能良好,质地柔软,色泽与受区接近,无局限性臃肿,筋膜瓣受力处无破溃,足部功能恢复良好。结论带小隐静脉-腓肠神经营养的逆行筋膜瓣手术方法简单,抗感染能力强,修复组织缺损效果满意。更多还原

【Abstract】 Objective To investigate the operative technique and clinical results of repairing soft tissue defects of the ankle and foot with reverse extended repair lesser saphenous vein-sural neurovascular fascial flap. Methods In the crural rear selective incision, free fascia flap was corresponded to the palpable posterior border of the fibula when mapped to the surface.The pivot point was placed at the level of the ankle joint distally, repairing soft tissue defects of the ankle and foot with reverse extended repair nutrition fasciall flap.The flaps were designed with the size of 5 cm×4 cm-14 cm×12 cm. Donor sites were directy sutured. The surface of roots and fascia flap were repaired by pedicled skin graft. Results Followingup from 5 months to 2 years all 22 adipofascial flap survived after surgery. Partial inadequate venous return and distal superficial necrosis happened in only 2 cases, which also got secondary healing by anti-infective therapy. The donor sites reached primary healing completely. Appearance and function of the flaps were all satisfactory. The texture of adipofascial flap was soft and the color of flap was similar to that of normal skin. The foot function was excellent. Conclusions The surgical method with lesser saphenous vein-sural nerve nutrition fascial flap is simple. With strong anti-infection ability, satisfactory result in repairing parenchyma defects.更多还原