【摘要】 目的探讨腓肠神经营养血管岛状皮瓣临床应用特点。方法应用腓肠神经营养血管岛状皮瓣对小腿、踝周、足部皮肤缺损伴骨肌腱外露21例进行修复,其中4例修复前足背顺行皮瓣5例,逆行皮瓣16例。同时观察和测量腓肠神经的走行及合成以及腓动脉穿支的发出部位。结果21例皮瓣全部存活。腓肠神经(18例)吻合型12例,单干型4例,双干型2例,腓肠内侧皮神经与腓肠外侧皮神经的交通支吻合点在踝上11~14 cm者12例,其吻合点越低者,腓肠神经越短。腓动脉穿支18例其中15例在踝上4~7 cm范围内,另3例最高分支点分别位于踝上10、11、11.5 cm。结论腓肠神经营养血管岛状皮瓣,切取简单,不损伤主要血管,是修复小腿、踝周、足部皮肤缺损骨肌腱外露的理想供区,修复足跟时必须吻合神经。更多还原

【Abstract】 Objective To explore the clinical application characteristics of sural neurocutaneous island flaps. Methods Sural neurocutaneous island flaps were used to repair the skin defect accompanied bone and tendon exposure in the lower leg,around the ankle and foot in 21 cases,including 4 cases to repair the foreside of the foot back.Direct flap was used in 5 cases and reverse flap in 16 cases.Meanwhile the coverage and formation of sural nerve were surveyed together with the starting point of peroneal perforator. Results All the 21 sural flaps were survived,including sural nerve(18 cases) anastomose 12 cases,single trunk 4 cases,double trunk 2 cases.The anastomose site of medial sural cutaneous nerve and the communicating branch of lateral sural cutaneous nerve was at the point of 11～14 cm above the ankle in 12 cases.The lower was the anastomose site,the shorter was the sural nerve.The site is 4～7 cm above the ankle in 15 out of 18 sural nerve perforator branch cases,and the other 3 cases is 10、11、11.5 cm above the ankle respectively. Conclusions Sural neurocutaneous island flaps are easy to separate.Major arteries are not injured.It is the ideal flap to repair the skin defect accompanied by bone and tendon exposure in lower leg,around ankle and foot.The nerve must be anastomosed when repairing the heel.更多还原