Hallock G G
Division of Plastic Surgery, Allentown Hospital.
Plast Reconstr Surg. 1989 Apr;83(4):710-6. doi: 10.1097/00006534-198904000-00019.
Posterior skin loss of the distal lower leg enhances the risk of exposure of the Achilles tendon. Most commonly, these wounds are a sequela to peripheral vascular insufficiency or else posttraumatic in origin. As a consequence, local flaps or skin grafts frequently are inadequate options for achieving coverage. Free-tissue transfers have proven to be a reasonable alternative in these situations for preservation of tendon function or even limb salvage. In this series of 12 patients, small defects were best covered with fasciocutaneous flaps, whereas the larger and usually chronic, concomitantly suppurating wounds required muscle flaps. Eighty-three percent (10 of 12) of patients remained ambulatory with healed wounds, obviating the need for extremity amputation.
小腿远端后部皮肤缺损会增加跟腱暴露的风险。这些伤口最常见的是周围血管功能不全的后遗症，或者源于创伤后。因此，局部皮瓣或皮肤移植常常不是实现覆盖的合适选择。在这些情况下，游离组织移植已被证明是保留肌腱功能甚至挽救肢体的合理替代方法。在这组12例患者中，小的缺损最好用筋膜皮瓣覆盖，而较大且通常为慢性、伴有化脓的伤口则需要肌皮瓣。83%（12例中的10例）的患者伤口愈合后仍能行走，无需进行肢体截肢。
