Zhang Xu, Wang Xiaohua, Wen Sumin, Zhu Hongwei, Ning Zhiwen, Mi Xu, Li Chenglin, Yu Ruxia
Department of Microsurgery, The Second Hospital of Qinhuangdao, Chengde Medical College, Hebei, People's Republic of China.
Microsurgery. 2008;28(8):643-9. doi: 10.1002/micr.20529.
In this report, the posterior tibial artery (PTA) based multilobar combined flap is introduced for the repair of complex soft tissue defects. The flap was designed based on the perforatoring branches of PTA in the anterior soleus muscle septum, which supply the skin over the medial side of the calf and the entire soleus muscle. The saphenous nerve was included in one perforator flap of the combined flap for reinnervation. The tibial artery was repaired with a vein graft after harvest of flap. From October 2005 to February 2007, eight patients (6 males, 2 females) underwent PTA-based multilobar combined flap transfer for coverage of soft tissue defects involving the foot (three cases), hand (two cases), and calf (three cases). Each combined flap composed of two to three perforator flaps, and the size of the perforator flaps ranged from 4 x 2 cm to 10 x 8 cm. With an average follow-up of 6 months, all flaps survived without complications and injured extremities showed a good functional recovery with restoration of the partial protective sensation on the flap with reinnervation. This clinical report has shown that a reliable multilobar combined flap can be designed based on the perforators of the posterior tibial artery and used for coverage of the complex wound.
在本报告中，介绍了基于胫后动脉（PTA）的多叶联合皮瓣用于修复复杂软组织缺损。该皮瓣基于比目鱼肌前间隔内胫后动脉的穿支进行设计，这些穿支为小腿内侧皮肤及整个比目鱼肌供血。隐神经被包含在联合皮瓣的一个穿支皮瓣内用于神经再支配。切取皮瓣后，用静脉移植修复胫后动脉。2005年10月至2007年2月，8例患者（6例男性，2例女性）接受了基于PTA的多叶联合皮瓣转移术，以覆盖足部（3例）、手部（2例）和小腿（3例）的软组织缺损。每个联合皮瓣由两到三个穿支皮瓣组成，穿支皮瓣大小从4×2厘米至10×8厘米不等。平均随访6个月，所有皮瓣均存活且无并发症，受伤肢体功能恢复良好，皮瓣经神经再支配后恢复了部分保护性感觉。本临床报告表明，基于胫后动脉穿支可设计出可靠的多叶联合皮瓣，用于覆盖复杂创面。
