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游离胫后动脉穿支皮瓣在手或足背部皮肤缺损中的应用

[Application of free posterior tibial artery perforator flap for skin defect on the dorsum of hand or foot].

作者信息

Zhao Feng-Jing, Zhang Xing-Qun, Yao Jian-Min, Ma Liang, Zhang Long-Chun, Chen Ying

机构信息

Hangzhou Plastic Surgery Hospital, Hangzhou 310014, China.

出版信息

Zhonghua Zheng Xing Wai Ke Za Zhi. 2011 Nov;27(6):418-20.

Abstract

OBJECTIVE

To summarize the technique and therapeutic effect of free posterior tibial artery perforator (PTP) flap for skin defect on the dorsum of hand or foot.

METHODS

The lower leg was divided into 6 sections equally from the level of tibial tuberosity to the connection of medial and lateral malleolus. The free PTP flap was designed along the inner edge of tibia within the proximal section 2 and 3. The flap was harvested with 2-3 bundles of the saphenous nerve included. The size of skin defects on the dorsum of hand or foot ranged from 3.0 cm x 7.5 cm to 6.0 cm x 12.0 cm.

RESULTS

From Jan. 2009 to Dec. 2010, 11 cases were treated with free PTP flaps. All the flaps survived completely. The follow-up period ranged from 3 to 10 months. The flaps had good color and texture. Two point discrimination recovered to 7-10 mm, leaving linear scar at the donor site. The appearance and function of the hand or foot was satisfactory.

CONCLUSIONS

The free PTP flap is thin with good sensation, leaving less morbidity at donor site. The posterior tibial artery can be reserved. It is an ideal method for skin defect on the dorsum of hand or foot.

摘要

目的

总结游离胫后动脉穿支(PTP)皮瓣修复手足背皮肤缺损的技术方法及治疗效果。

方法

将小腿自胫骨结节平面至内外踝连线处等分为6段。游离PTP皮瓣在近端第2、3段沿胫骨内侧缘设计。切取皮瓣时包含2 - 3束隐神经。手足背皮肤缺损面积为3.0 cm×7.5 cm至6.0 cm×12.0 cm。

结果

2009年1月至2010年12月,11例患者接受游离PTP皮瓣治疗。所有皮瓣均完全成活。随访3至10个月。皮瓣色泽、质地良好。两点辨别觉恢复至7 - 10 mm,供区遗留线状瘢痕。手足外观及功能满意。

结论

游离PTP皮瓣薄,感觉良好,供区损伤小,可保留胫后动脉。是修复手足背皮肤缺损的理想方法。

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