Rajendra Prasad J S, Cunha-Gomes D, Chaudhari C, Bhathena H M, Desai S, Kavarana N M
Department of Plastic & Reconstructive Surgery, Tata Memorial Hospital, Mumbai, India.
Br J Plast Surg. 2002 Apr;55(3):203-9. doi: 10.1054/bjps.2001.3818.
Reconstruction of soft-tissue defects of the lower third of the leg, the heel and the foot remains a challenge. The distally based sural neurocutaneous flap has been used effectively to resurface these defects. However, the paucity of bulk in this flap makes it inadequate for complex post-traumatic or post-ablative soft-tissue reconstruction. We dissected 20 freshly amputated lower limbs after injecting them with a mixture of lead oxide and gelatin. We found muscular branches of the accompanying artery of the sural nerve to the gastrocnemius muscle in all 20 limbs. This led us to conceptualise the distally based venoneuroadipofascial pedicled island sural myofasciocutaneous and muscle flaps. These flaps are useful for the reconstruction of complex soft-tissue defects of the lower third of the leg, the heel and the foot.
小腿下三分之一、足跟和足部软组织缺损的重建仍然是一项挑战。以远端为蒂的腓肠神经营养皮瓣已被有效地用于修复这些缺损。然而，该皮瓣组织量不足，不足以用于复杂的创伤后或切除术后软组织重建。我们在20条新鲜截肢的下肢注射氧化铅和明胶混合物后进行解剖。我们在所有20条下肢中均发现了腓肠神经伴行动脉至腓肠肌的肌支。这使我们构思出以远端为蒂的静脉神经脂肪筋膜蒂岛状腓肠肌肌筋膜皮瓣和肌肉瓣。这些皮瓣对于小腿下三分之一、足跟和足部复杂软组织缺损的重建很有用。
