外踝上穿支皮瓣解剖分析与临床应用

摘要

Objective Reports on the improving external ankle perforators flap surgical method and clinical application. Artery through the law and the nutrition of skin flap, designed for clinical external ankle perforators flap to provide morphological basis, and in clinical application. Methods On the basis of anatomical observation on the design with external ankle perforators rise to vascular pedicle, ligation its descending branch, cut on the outside of the calf skin flap transposition repair period of the leg and foot skin soft tissue defect. Results Clinical application of 14 cases, and all flaps survived, flap area of by 7 cm× 12 cm~16 cm×23 cm, wear long vascular pedicle 1.6~2.8 cm. Were followed up for 6~18 months, the flap with the surrounding skin, slightly swollen, obtained satisfactory appearance of the patient, and good functional recovery. Conclusion Design with terminal branch of the peroneal artery perforators flap, ligation its descending branch, using its exist widely with other wear vascular anastomosis, can take on large areas of external ankle cut, perforators flap transposition to repair large area of the foot wound, simple operation, high survival rate of flap.%目的：探讨改进外踝上穿支皮瓣的手术方法及临床效果。方法在解剖观测基础上设计以外踝上穿支升支为血管蒂，结扎其降支，在小腿外侧以腓动脉皮支穿出点连线为皮瓣轴线设计切取皮瓣，转位修复小腿中下段及足踝部皮肤软组织缺损。结果本组14例皮瓣全部成活，皮瓣面积7 cm×12 cm～16 cm×23 cm，穿支血管蒂长1.6～2.8 cm。术后随访6～18个月，皮瓣肤色与周围相近，略臃肿，外观较为满意，创区功能恢复好。结论解剖研究为临床外踝上穿支皮瓣手术提供解剖学依据，经改进的外踝上穿支皮瓣为足踝部大面积皮肤缺损的修复提供了一种实用性新方法。