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逆行腓浅神经皮岛状皮瓣在踝关节和足部创面覆盖中的多功能性

Versatility of the reversed superficial peroneal neurocutaneous island flap in the coverage of ankle and foot.

作者信息

Lu Shengdi, Wang Chunyang, Wen Gen, Han Pei, Chai Yimin

机构信息

From the Department of Repair and Reconstruction Surgery, Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, China.

出版信息

Ann Plast Surg. 2015 Jan;74(1):69-73. doi: 10.1097/SAP.0000000000000054.

Abstract

BACKGROUND

In the last decades, the skin island flap supplied by the vascular axis of sensitive superficial nerves, like the sural and saphenous nerves, has emerged as one of the most ideal reconstructive options for soft tissue coverage of lower limbs. The nutrient vessels of reversed superficial peroneal neurocutaneous island flap have been well described; however, it is still not commonly clinically applied. The aim of this study was to evaluate the efficacy of reversed superficial peroneal neurocutaneous island flap for coverage of ankle and foot.

STUDY DESIGN

This is a retrospective and descriptive study of reversed superficial peroneal neurocutaneous island flap which was carried out for reconstruction of ankle and foot.

PLACE AND DURATION OF STUDY

This study was conducted at the Department of Repair and Reconstructive Surgery, the 6th People's Hospital affiliated to Shanghai Jiaotong University, during a period of 51 months from July 2008 to October 2012.

PATIENTS AND METHODS

A total of 12 patients with soft tissue defect of ankle and foot were included in the series; reversed superficial peroneal neurocutaneous island flap was performed on each case if relevant indications permitted. Preoperative and postoperative data of each patient, including etiology, size of defect, dimension of flap, complications, and functional and aesthetic results were noted.

RESULTS

Among the 12 patients, there were 8 men and 4 women with an average age of 40.7 years (22-65 years) and with a mean follow-up time of 17.3 months (10-23 months). Most patients (11 patients) were posttraumatic. The size of the flap ranged from 48 to 108 cm2. Postoperatively, 11 flaps survived uneventfully, whereas marginal venous congestion was seen in the remaining patient, and secondary healing was achieved by conservative treatment.

CONCLUSIONS

The reversed superficial peroneal neurocutaneous island flap could be an excellent alternative to other neurocutaneous perforator flap in the soft tissue reconstruction of foot and ankle.

摘要

背景

在过去几十年中,由腓肠神经和隐神经等感觉性浅神经血管轴供血的皮岛皮瓣,已成为下肢软组织覆盖最理想的重建选择之一。逆行腓浅神经营养血管皮岛皮瓣的营养血管已得到充分描述;然而,它在临床上仍未得到广泛应用。本研究的目的是评估逆行腓浅神经营养血管皮岛皮瓣覆盖踝和足部的疗效。

研究设计

这是一项对逆行腓浅神经营养血管皮岛皮瓣进行的回顾性描述性研究,该皮瓣用于踝和足部的重建。

研究地点和时间

本研究于2008年7月至2012年10月的51个月期间,在上海交通大学附属第六人民医院修复重建外科进行。

患者和方法

本系列共纳入12例踝和足部软组织缺损患者;若有相关适应症,对每例患者均实施逆行腓浅神经营养血管皮岛皮瓣手术。记录每位患者术前和术后的数据,包括病因、缺损大小、皮瓣尺寸、并发症以及功能和美学效果。

结果

12例患者中,男性8例,女性4例,平均年龄40.7岁(22 - 65岁),平均随访时间17.3个月(10 - 23个月)。大多数患者(11例)为创伤后患者。皮瓣面积为48至108平方厘米。术后,11例皮瓣顺利存活,其余1例患者出现边缘静脉淤血,经保守治疗后二期愈合。

结论

在足踝部软组织重建中,逆行腓浅神经营养血管皮岛皮瓣可能是其他神经营养血管穿支皮瓣的极佳替代方案。

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