Koshima Isao, Nanba Yuzaburo, Tsutsui Tetsuya, Takahashi Yoshio
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1, Shikata, Okayama City, Okayama, Japan 700-8558.
Clin Plast Surg. 2003 Jul;30(3):447-55, vii. doi: 10.1016/s0094-1298(03)00044-0.
Since the 1980s, the concept of the perforator flap has been modified to include new perforator flaps. A medial plantar perforator flap, which has no fascial component and is nourished only with perforators of the medial plantar vessel and a cutaneous vein, or with a small segment of the medial plantar vessel, was developed. A free medial plantar perforator flap was successfully transferred for coverage of a soft-tissue defect in the finger. The advantages of this flap are minimum donor site morbidity, minimum damage to the posterior tibial and medial plantar systems, no need for deep dissection, possible thinning of the flap with primary defatting, a short time for flap elevation, use of a large cutaneous vein as a venous drainage system, a good color and texture match for finger pulp repair, a concealed donor scar, and possible application as a flow-through flap as a free flap and an island perforator flap for plantar weight-bearing defects.
自20世纪80年代以来，穿支皮瓣的概念已被修改，以纳入新的穿支皮瓣。一种内侧足底穿支皮瓣被开发出来，它没有筋膜成分，仅由内侧足底血管的穿支和一条皮静脉或一小段内侧足底血管供血。游离内侧足底穿支皮瓣已成功用于修复手指的软组织缺损。该皮瓣的优点包括供区并发症最少、对胫后和内侧足底系统损伤最小、无需深部解剖、可通过初次去脂使皮瓣变薄、皮瓣掀起时间短、使用一条大的皮静脉作为静脉引流系统、用于修复指腹时颜色和质地匹配良好、供区瘢痕隐蔽，以及作为游离皮瓣和岛状穿支皮瓣用于足底负重缺损时可作为血流通过皮瓣应用。
