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端侧吻合法在游离腓肠内侧动脉穿支皮瓣中的应用

邱海胜 倪晓 余方正 张雷

邱海胜, 倪晓, 余方正, 张雷. 端侧吻合法在游离腓肠内侧动脉穿支皮瓣中的应用[J]. 中华全科医学, 2024, 22(11): 1846-1849. doi: 10.16766/j.cnki.issn.1674-4152.003747
引用本文: 邱海胜, 倪晓, 余方正, 张雷. 端侧吻合法在游离腓肠内侧动脉穿支皮瓣中的应用[J]. 中华全科医学, 2024, 22(11): 1846-1849. doi: 10.16766/j.cnki.issn.1674-4152.003747
QIU Haisheng, NI Xiao, YU Fangzheng, ZHANG Lei. Application of end-to-side arterial anastomosis in transplantations of medial sural artery perforator flap[J]. Chinese Journal of General Practice, 2024, 22(11): 1846-1849. doi: 10.16766/j.cnki.issn.1674-4152.003747
Citation: QIU Haisheng, NI Xiao, YU Fangzheng, ZHANG Lei. Application of end-to-side arterial anastomosis in transplantations of medial sural artery perforator flap[J]. Chinese Journal of General Practice, 2024, 22(11): 1846-1849. doi: 10.16766/j.cnki.issn.1674-4152.003747

端侧吻合法在游离腓肠内侧动脉穿支皮瓣中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003747
基金项目: 

浙江省基础公益研究计划项目 LBY21H060001

详细信息
    通讯作者:

    倪晓,E-mail:nixiaoxiaoni@126.com

  • 中图分类号: R622.1

Application of end-to-side arterial anastomosis in transplantations of medial sural artery perforator flap

  • 摘要:   目的  探讨动脉端侧吻合的游离腓肠动脉穿支皮瓣移植修复手足部软组织缺损的临床疗效。  方法  选取2015年3月—2023年7月温州医科大学附属第一医院手外科采用腓肠内侧动脉穿支皮瓣修复手足部软组织缺损创面患者16例。所有患者均为受区一条主干血管已损伤或主干血管太粗无法匹配腓肠内侧动脉。皮瓣切取面积为(3.0 cm×5.0 cm)~(12.0 cm×7.0 cm),供区均直接缝合。其中动脉均采用腓肠动脉与受区主干血管的端侧吻合。修复足部创面时,皮瓣供区选同侧小腿;修复手部创面时,皮瓣供区可选同侧或对侧小腿。  结果  16块皮瓣动脉均顺利吻合,皮瓣均顺利成活,本组病例未发生血管危象。术后随访2个月~3年, 平均1年,皮瓣无明显回缩,皮瓣色泽与受区相似,质地良好,肢体血供佳,感觉正常。16例供区均直接缝合, 均愈合良好,仅留线型疤痕。末次随访时手部功能评定:9例为优,3例为良;足部功能评定:4例均为优;16例患者对供区及受区皮瓣外观均满意。  结论  游离腓肠动脉穿支皮瓣不损伤供区主干血管,相对隐蔽,中小皮瓣供区均能直接缝合,损伤较小。应用端侧吻合的游离腓肠动脉穿支皮瓣既不用考虑受区血管的匹配,又能减少受区主干血管的损伤,提高皮瓣的成活率。此术式是临床修复手足部创面的良好方法。

     

  • 图  1  右足软组织缺损创面

    Figure  1.  Right foot soft tissue defect

    图  2  右小腿腓肠内侧动脉穿支皮瓣设计

    Figure  2.  Design of a medial sural artery perforator flap on the right calf

    图  3  腓肠内侧动脉穿支

    Figure  3.  Perforating branch of the medial sural artery

    图  4  带穿支的皮瓣游离后

    Figure  4.  Free flap after perforating branch surgery

    图  5  皮瓣供区后期仅留线型疤痕

    Figure  5.  In the later stage, only linear scars remain in the flap donor area

    图  6  皮瓣覆盖术后2个月

    Figure  6.  Two months after skin flap coverage surgery

    图  7  术中动脉端侧吻合中

    Figure  7.  Intraoperative end-to-end arterial anastomosis

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出版历程
  • 收稿日期:  2024-01-16
  • 网络出版日期:  2024-12-31

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