腓肠神经逆行岛状皮瓣修复下肢远端软组织缺损

发布时间：2019-06-10 01:01

【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~6.0cm×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。
[Abstract]:Objective to investigate the clinical effect of sural nerve reverse island flap in repairing distal skin and soft tissue defect of lower extremity. Methods from November 2009 to June 2014, 52 cases (41 males and 11 females) of distal lower extremity skin and soft tissue defects were repaired with sural neurovascular reverse island flap. The youngest is 5 years old, the oldest is 64 years old, the average is 37.3 years old. Soft tissue defect area 4.0 cm 脳 4.5 cm~6.0cm 脳 12.0 cm, flap with an area of 4.5 cm 脳 5.0 cm~7.0 cm 脳 15.0 cm. The time from injury to operation is 9 to 45 days. The flap was removed from the injured sural nerve in 21 cases. The small saphenous vein was not ligated in the pedicle of the flap in 52 cases. Results there were no edema, congestion, blistering and other venous stasis of the flap after operation, and all of them survived. There were 39 cases of wound stage I healing and 3 cases of mild infection under skin flap, which were controlled by dressing change treatment. The wound is not broken again, the color of the flap is normal, the shape is satisfactory, and the texture of the flap is good. The skin flap was followed up for 8 to 24 months (mean 9 months). The flap had no ulcer, good color and good function. Conclusion reverse sural nerve island flap is an ideal choice for repairing distal soft tissue defect of lower extremity, and can be used regardless of sural nerve injury or not.
【作者单位】：华北理工大学;唐山市第二医院;
【基金】：河北省医学适用技术跟踪项目(G2015079)
【分类号】：R658.3

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