Objective To investigate the effect of modified distally based propeller sural perforator flap for defect at foot and ankle and lateral gastrocnemius artery perforator flap for defect at donor site. Methods From January 2014 to January 2016, 12 cases with defects at foot and ankle were reconstructed by modified distally based propeller sural perforator flaps. The result ed defects at donor sites were reconstructed by lateral gastrocnemius artery perforator flaps. The flaps size ranged from 5. 5 cm × 3. 5 cm to 13. 0 cm × 7. 0 cm for modified distally based propeller sural perforator flaps, and 7. 0 cm × 4. 0 cm to 10. 0 cm × 6. 0 cm for lateral gastrocnemius artery perforator flaps. The 12 cases included 10 males and 2 females, aged from 14 to 48 years (25. 7 years on average). Results The lateral gastrocnemius artery perforators existed consistently in all cases. All flaps survived completely with no vascular crisis, wound dishesecense or obvious swelling. Primary healing was achieved in both recipient and donor sites. 12 cases were followed up for 6 -14 months ( 12. 4 months on average ) with satisfactory esthetic and functional result in both recipient and donor sites, only linear scar was left on the donor sites. Conclusions The lateral gastrocnemius artery perforator flap is suitable for defect left by modified distally based propeller sural perforator flap. Combination of the two flaps is an optional choice for defects at foot and ankle.%目的 探讨改良螺旋桨腓动脉穿支皮瓣修复足踝缺损,并用腓肠外侧动脉穿支皮瓣修复供区的效果.方法 2014年1月至2016年1月,采用改良螺旋桨腓动脉穿支皮瓣对12例足踝部皮肤软组织缺损创面进行修复,供区采用腓肠外侧动脉穿支皮瓣转移修复.腓动脉穿支皮瓣面积为5.5 cm×3.5 cm～13.0 cm×7.0 cm,腓肠外侧动脉穿支皮瓣面积为7.0 cm×4.0 cm～10.0 cm×6.0 cm.结果 所有患者均有恒定的腓肠外侧动脉穿支存在,术后所有皮瓣均顺利成活,未发生血管危象、伤口裂开和明显肿胀等情况,供、受区创面均一期愈合.12例获得6～14个月随访,平均12.4个月,皮瓣供区仅遗留线性瘢痕,小腿和足踝功能未受明显影响,颜色及外观自然.结论 腓肠外侧动脉穿支皮瓣可以较好地修复改良腓动脉穿支皮瓣供区,2种皮瓣联合切取移位是修复足踝部缺损的较好选择.
展开▼
