【摘要】 目的 报告带腓肠神经营养血管蒂逆行岛状筋膜皮瓣的临床运用效果。

    方法 对32例小腿下段及足踝部软组织缺损的病例，采用带腓肠神经营养血管蒂逆行岛状筋膜皮瓣修复，其中创伤致软组织缺损20例，慢性溃疡8例，瘢痕切除术后4例。皮瓣面积最大14cm×10cm，最小5cm×4cm。

    结果 30例皮瓣全部存活，2例远端部分坏死，经游离植皮后创面愈合，所有软组织缺损均修复，骨骼、肌腱外露均覆盖。随访5个月～2年，平均1年，皮瓣质地优良，外观及功能满意。

    结论 该皮瓣血运可靠，手术操作及设计简便，不损伤小腿的主要血管，可理想修复足跟、内外踝、跟腱区和小腿下1/3软组织缺损。

    【关键词】 腓肠神经；外科皮瓣；软组织缺损；修复

    The clinical application of reversed sural neurovascular rascio-cutaneous island flap

    KUANG Ya-hua,DONG Zhong-gen.

    Department of Orthopaedics,The Affiliated Second Hospital of Xiangya Medical College to The Central South University,Changsha 410000,China

    【Abstract】 Objective To report the results of reversed sural neurovascular fascio cutaneous island flap in clinical application.Methods From March 1998 to May 2003,32 patients with soft tissue defects around the heel,malleolus,achilles tendon and the low 1/3 part of anterior tibial were reconstructed by use of reversed sural neurovascular fascio -cutaneous island flap,including 20 cases of traumatic defects,8 cases of chronic ulcer and 4 cases of scar tissue.The sizes of the flaps used ranged from 14cm×10cm to 5 cm×4cm.Results The flaps totally survived in 30 patients,the distal part necrosed and secondary free-skin graft were further conducted in 2 cases.All soft tissue defects were repaired and their accompanied bone and tendon exposure healed.Their appearance and function were satisfactory after an average of a year follow-up (ranged from 5 to 2 years).Conclusion This kind of flap had reliable blood supply and convenient in design and dissesction and had the character of avoidance of the major arteries.It was satisfactory in repairing the soft tissue defects around the heel,malleolus,achilles tendon and the low 1/3 part of anterior tibial. ......