Objective: To investigate the selecting principal to repair the shank soft tissue traumatic defect by the local pedicled skin flaps. Methods: A total of 226 cases between January 1999 and December 2009 were collected. The shank soft tissue traumatic defects from different regions, different extent and different conditions were repaired respectively by clockwise or reversed pedicled skin flaps and other typologic skin flaps with axial pattern blood vessel or neurocutaneous vascular flap as well as fascio - cutaneous flap. Results: A total of 186 cases in 226 flaps had a good healing, 6 cases had a chronic sinus tract, and the skin edges of the 21 fascio -cutaneous flaps and sural neuromusculocutaneous flaps had the necrosis, all healed by changing dressings, the other 13 sural neuromusculocutaneous flaps had a postoperative grey skin edge in the distal end, but didn' t affect to heal. The 6 musculocutaneous flaps appeared fat and clumsy and all the supplied petaloid area had a better skingrafting healing. The pitting gradually became shallow alongwith the postoperative time. Conclusion: It has an ideal reconditioning effect to repair the shank soft tissue traumatic defect by the prothesis of local pedicled skin flaps, based on the appropriate selecting principal .%目的:探讨小腿部外伤性组织缺损使用局部带蒂皮瓣修复术式的选择原则.方法:选取1999-01～2009-12间226例小腿部不同部位、不同程度、不同条件的组织缺损,分别采用带蒂的顺、逆行皮瓣、以及其他类型的轴型血管皮瓣和神经营养血管皮瓣及筋膜皮瓣进行修复.结果:226例皮瓣中186例愈合过程顺利.余40例皮瓣中6例发生慢性窦道,21例筋膜皮瓣及腓肠神经营养皮瓣皮缘坏死,均经换药治愈；13例腓肠神经营养血管皮瓣术后远端皮缘色泽暗紫,未影响愈合；6例肌皮瓣外观臃肿,供瓣区植皮愈合良好.凹陷情况随着术后时间的延长逐渐变浅.结论:采用局部带蒂皮瓣修复术式修复小腿部外伤性组织缺损,在恰当把握皮瓣选择的原则基础上,可取得理想的修复效果.
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