中国现代手术学杂志2011，Vol.15Issue(3)：178-182,5.
远端蒂腓肠神经营养血管皮瓣修复小腿下段胫前创面的手术技巧
Surgical Techniques in the Repairing of Pretibial Soft-tissue Defect of Distal Lower Leg with Distally Based Sural Neurofasciocutaneous Flap
张志国 1董忠根 2魏建伟 2刘立宏 2倪江东 2罗顺红 2罗兆彪 2左建伟 2孙雨峰2
作者信息
- 1. 湖南省地矿医院骨科,长沙,410007
- 2. 中南大学湘雅二医院骨科一病区,长沙,410011
- 折叠
摘要
Abstract
Objective To explore the surgical techniques to increase the success rate of distally based sural neurofasciocutaneous flaps in reconstruction of pretibial soft-tissue defects in distal lower legs. Methods Forty-eight distally based sural neurofasciocutaneous flaps were conducted to cover pretibial soft-tissue defect in the distal lower legs. The flaps were harvested by antegrade-retrograde combined techniques. The position of pivot point and skin paddle was adjusted in 8 flaps during the operation. Skin paddle was designed to be oblique in 7 flaps to reconstruct the longitudinal defects. Eight flaps were transferred via back of Achilles tendon. Twelve flaps were used in a fashion of peninsula flap. Results Out of the 48 flaps,42 flaps survived completely; distal epidermal necrolysis appeared in 2 flaps; distal partial necrosis occurred in 4 (8.3％) flaps, and cured by changing dressings (1 case) , secondary suture (2 cases) and skin grafting ( 1 case). Conclusion The surgical techniques can increase the successful rate of distally based sural neurofasciocutaneous flaps to reconstruct pretibial soft-tissue defect in the distal lower legs, including antegrade-retrograde combined skills to harvest flaps, oblique flaps designed to cover the suitable longitudinal defect, reasonable transposition route and peninsula flaps selected and other measures to decrease the tension of fascial pedicle and skin paddle.关键词
腓肠神经/外科皮瓣/腿损伤/软组织损伤Key words
sural nerve/ surgical flaps/ leg injuries/ soft tissue injuries分类
医药卫生引用本文复制引用
张志国,董忠根,魏建伟,刘立宏,倪江东,罗顺红,罗兆彪,左建伟,孙雨峰..远端蒂腓肠神经营养血管皮瓣修复小腿下段胫前创面的手术技巧[J].中国现代手术学杂志,2011,15(3):178-182,5.
