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目的探讨以腓动脉终末支为蒂携带多个穿支血管的小腿外侧皮瓣修复幼儿足踝部大面积软组织缺损的临床效果。方法足踝部大面积软组织缺损患儿7例,年龄1~3岁,平均年龄2.3岁,以腓动脉走形为轴线切取小腿外侧皮瓣,均携带2~5支腓动脉穿支血管,远端蒂部解剖至腓动脉终末支近端周围,完全裸化其周边筋膜组织,皮瓣切取面积大小为5 cm×8 cm~6 cm×10 cm,供区创面一期腹部全厚皮打包加压。结果 6例皮瓣顺利成活,1例皮瓣远端约1.5 cm边缘坏死,经换药后愈合。术后随访3~12个月,平均7.5个月,皮瓣色泽、质地与周围组织接近,5例进行了二期皮瓣修整,其中3例行趾伸肌腱缺损修复重建术,术后患足功能和外形均满意。结论以腓动脉终末支为蒂携带多个穿支血管的小腿外侧皮瓣可以移位修复足踝部较大面积皮肤软组织缺损,血管解剖恒定,血运丰富,操作简单。
Objective To investigate the clinical effect of pedicled peroneal pedicle graft pedicled with perforator pedicel pedicle to repair large area soft tissue defects of ankle and foot in children. Methods 7 cases of large area soft tissue defects in the foot and ankle were aged 1 to 3 years with a mean age of 2.3 years. The lateral flaps of the calf were excised from the shape of the peroneal artery and carried 2 to 5 perforators, End peduncles were dissected to the proximal end of the peroneal artery around the end of the complete nudity of the surrounding fascia, the skin flap size of 5 cm × 8 cm ~ 6 cm × 10 cm for the wound area of a full-thickness abdominal belly Packaged pressure. Results The flaps survived successfully in 6 cases, and the distal margin of 1 flap was necrosed at about 1.5 cm. Healed after dressing change. The patients were followed up for 3 to 12 months with an average of 7.5 months. The flap color and texture were similar to those of the surrounding tissues. Five cases underwent second-stage skin flap trimming. Among them, 3 cases received extensor tendon defect repair and reconstruction, Function and appearance are satisfied. CONCLUSION: The lateral flap of the calf, which carries multiple perforator vessels pedicled with the terminal branch of the peroneal artery, can displace the large area of skin and soft tissue defects in the foot and ankle. The vascular anatomy is constant, blood supply is abundant and the operation is simple.