Sun Guangfeng, Nie Kaiyu, Qi Jianping, Jin Wenhu, Li Shujun, Zhang Ziyang, Wei Zairong, Wang Dali
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Mar;30(3):378-81.
To investigate the effectiveness of the free medial sural artery perforator flap for repairing anterior dorsal foot wound.
Between January 2010 and April 2015, 16 patients with skin and soft tissue defects of the anterior foot dorsal side were treated. There were 12 males and 4 females with the average age of 35 years (mean, 16-58 years). The disease causes included burn in 5 cases, traffic accident injury in 8 cases, and crush injury in 3 cases. The time from injury to admission was 2-30 hours (mean, 6.5 hours). The wound area ranged from 4 cm x 3 cm to 10 cm x 7 cm; combined injury included defects of lateral collateral ligament and joint capsule in 3 cases, and bone exposure in 12 cases, and all had exposure of tendon. Wounds were repaired with the medial sural artery perforator flap in 13 cases, and with medial sural artery perforator composite tissue flap carrying of medial head of gastrocnemius muscle flap in 3 cases. The size of flaps ranged from 5 cm x 4 cm to 11 cm x 8 cm. The donor site was sutured directly or was repaired with skin grafting.
All flaps survived well and wounds healed with stage I; skin grafts at donor site survived and the incision healed with stage I. All patients were followed up 6-36 months (mean, 11 months). The appearance of skin flap was satisfactory, without overstaffed; the joint of reconstructed ligament was stable, without secondary deformity. There was no obvious depression at the donor site, and no effect on the function.
The medial sural artery perforator flap has the advantages of relatively constant perforator anatomy, reliable blood supply, and carries the gastrocnemius muscle flap for repair of compound tissue defect. It is one of better ways to repair the anterior dorsal foot wound.
探讨腓肠内侧动脉穿支皮瓣修复足背前侧创面的疗效。
2010年1月至2015年4月,收治16例足背前侧皮肤软组织缺损患者。其中男12例,女4例,平均年龄35岁(16~58岁)。致伤原因:烧伤5例,交通事故伤8例,挤压伤3例。受伤至入院时间为2~30小时(平均6.5小时)。创面面积4 cm×3 cm至10 cm×7 cm;合并伤包括外侧副韧带及关节囊缺损3例,骨质外露12例,均有肌腱外露。13例行腓肠内侧动脉穿支皮瓣修复,3例行携带腓肠肌内侧头肌瓣的腓肠内侧动脉穿支复合组织瓣修复。皮瓣大小5 cm×4 cm至11 cm×8 cm。供区直接缝合或植皮修复。
所有皮瓣均成活良好,创面Ⅰ期愈合;供区植皮成活,切口Ⅰ期愈合。所有患者随访6~36个月(平均11个月)。皮瓣外观满意,无臃肿;重建韧带关节稳定,无继发畸形。供区无明显凹陷,对功能无影响。
腓肠内侧动脉穿支皮瓣具有穿支解剖位置相对恒定、血供可靠的优点,且可携带腓肠肌瓣修复复合组织缺损,是修复足背前侧创面较好的方法之一。