摘要
目的探讨以邻近非主干血管为蒂皮瓣转移修复小腿中下段皮肤缺损的优化选择. 方法分析42例病例,应用4种邻近非主干血管为蒂皮瓣进行修复.小腿中下段软组织缺损周围皮肤条件良好者,选择邻近的逆行腓肠神经、隐神经营养血管皮瓣或腓肠肌皮瓣;如周围皮肤有较轻损伤,用腓肠肌皮瓣;皮肤缺损范围大者,组合逆行腓肠神经营养血管皮瓣与肌瓣或腓肠肌皮瓣;创面较小,选用比目鱼肌肌瓣或腓骨短肌瓣. 结果所有病例随访6～12个月,成活37例,5例远端少部分坏死,2例局部皮瓣转移修复,1例肌瓣转移,2例肉芽组织生长后植皮修复.结论邻近非主干血管为蒂皮瓣转移修复小腿中下段皮肤缺损是最佳修复方式,不同的术式可满足各种创面的要求.
Objective To explore the improving way to repair the lower one-third of leg soft tissue defeet transferred the adjacent flap with non-main vessel pedicle. Methods Analyzing 42 cases, using 4 kinds flaps with non-main vessel pedicle. If it is fine the skin around soft tissue defect of the lower one-third shank, choosing adjacent adversed sural neurotaneous vascular flap or sapheenous nerve vascular flap. If the skin damaged, ehosing gastrocnemius flap. If the soft tissue defect was large, combined adversed sural neurotaneous vascular flap with gastrocnemius flap. Osteomyelitis and peroneus previs musculocutaneous flaps were choosed for small soft tissue defect. Results All case observed 6 to 12 months, 37 cases were survived completely, 5 cases distal part necrsis partly, among them, 2 cases transferred flap repaired; 1 case musculocutaneous flap transferred, 2 cases after granulation tissue grown, skin grafted. Conclusion The flap transferred adjacent non-main vessel pedicle is the best way to repaire soft tissue defect of one-third lower leg. Different flap can fit with kinds of soft tissue defect.
出处
《中华显微外科杂志》
CSCD
北大核心
2005年第4期305-306,共2页
Chinese Journal of Microsurgery
