Zgonis Thomas, Cromack Douglas T, Stapleton John J
Department of Orthopaedics, The University of Texas Health Science Center at San Antonio 78229, USA.
Int J Low Extrem Wounds. 2007 Jun;6(2):114-9. doi: 10.1177/1534734606298166.
Extensive soft tissue defects involving the weight-bearing areas of the plantar aspect of the foot often require coverage with flaps. The options often include free flaps, free muscle flaps with split-thickness skin grafting, or local flaps. When presented with high-energy-induced soft tissue injuries of the foot, choices become narrow, secondary to the associated zone of injury. Free flaps require a viable recipient vessel suitable for microvascular anastomosis. Split-thickness skin grafts applied to the plantar aspect of the foot are prone to persistent breakdown. Local flaps if available are useful for coverage of plantar soft tissue defects. However, when local flaps of the affected limb are compromised or extension is not sufficient for coverage, crossover leg and foot flaps become invaluable. The reported cases of crossover sural artery flaps are sparse. To the best of the authors' knowledge, the few reported cases of crossover leg and sural artery flaps were described to provide soft tissue coverage over the heel and leg. The authors report a case of a crossover reverse sural artery flap for soft tissue coverage to the plantar aspect of the forefoot after a high-energy-induced degloving injury.
累及足底负重区的广泛软组织缺损通常需要皮瓣覆盖。常用的选择包括游离皮瓣、带刃厚皮片移植的游离肌皮瓣或局部皮瓣。当面对足部高能致伤的软组织损伤时，由于相关损伤区域的影响，选择范围会变窄。游离皮瓣需要一条适合微血管吻合的有活力的受区血管。应用于足底的刃厚皮片容易持续破溃。如果有可用的局部皮瓣，对于覆盖足底软组织缺损很有用。然而，当患肢的局部皮瓣受损或其延伸不足以覆盖缺损时，交叉腿和足皮瓣就变得非常重要。报道的交叉腓肠动脉皮瓣病例很少。据作者所知，少数报道的交叉腿和腓肠动脉皮瓣病例是用于足跟和小腿的软组织覆盖。作者报告了1例交叉逆行腓肠动脉皮瓣用于覆盖前足足底高能致脱套伤后的软组织缺损。
