【摘要】 目的 研究应用结扎小隐静脉的腓肠神经营养血管筋膜皮瓣修复足部软组织缺损，并重建皮瓣感觉功能的临床效果。方法 2001年7月～2004年12月，对足部软组织缺损9例，男5例，女4例，年龄最大55岁，最小16岁，平均37.1岁。均应用腓肠神经营养血管筋膜皮瓣修复，其中车祸伤5例，机器挤压伤2例，烧伤1例，慢性溃疡1例。切取皮瓣范围5cm×6cm～14cm×20cm。结果 术后9例皮瓣全部成活；2例皮瓣远端边缘部分坏死，经换药及游离植皮后创面愈合。术后9例皮瓣经8个月～3年(平均2.1年)随访，均有一定程度的感觉恢复，术后20周进行感觉功能评定，S2 5例，S2+ 4例，S3 4例；供体神经功能无明显影响；其中7例皮瓣质量良好，踝关节功能良好，2例皮瓣弹性较差，踝关节功能受限。结论 腓肠神经营养血管皮瓣质地良好，神经重建后可恢复部分感觉，手术切取操作简便，成活率高，不损伤主要血管，是修复足部软组织缺损较为理想的方法。

    【关键词】 腓肠神经；外科皮瓣；修复

    Sural neurovascular fasciocutaneous flap for reconstruction of soft-tissue defects in foot

    WANG Lai-xu,WANG Xiao-fang,ZHOU Zhong-shui,et al.

    Department of Orthopaedic,Binzhou Central Hospital,Shandong 251700,China

    【Abstract】 Objective To evaluate clinical effects of sural neurovascular fasciocutaneous flap on sensational reconstruction and repair of soft-tissue defects in foot.And the lesser saphenous vein in flap was ligated.Methods From July 2001 to December 2004,9 cases of soft-tissue defects in feet were repaired by use of sural neurovascular fasciocutaneous flap,including 8 cases of traumatic defects,1 cases of chronic ulcer.The flap area ranged from 5cm×6cm to 14cm×20cm.Results The flaps survived in all cases:the distal part necrosed and secondary free-skin graft were further conducted in 2 cases.9 cases were followed-up for 8 months to 36 months,the color and texture of the flaps were excellent.The sensation of the flaps recovered in different degree.The functions of ankle joints were good.Conclusion Sural neurovascular fasciocutaneous flap is excellent in color and texture,convenient in design and dissection.It can be used for repair of soft-tissue defects in foot. ......