小隐静脉腓肠神经皮瓣修复足踝部软组织缺损.doc

小隐静脉腓肠神经皮瓣修复足踝部软组织缺损 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：小隐静脉腓肠神经皮瓣修复足踝部软组织缺损 1 1 一般资料 2 2 手术时机及手术方法 3 3 结果 3 4 讨论 4 文2：逆行腓肠神经皮瓣修复足踝部软组织缺损 6 1 资料与方法 6 2 结果 7 3 讨论 8 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 10 正文 小隐静脉腓肠神经皮瓣修复足踝部软组织缺损 文1：小隐静脉腓肠神经皮瓣修复足踝部软组织缺损 Recotruction of the Soft Tissue Defects on Foot and Ankle with Sural Neurovenofasciocutaneousisland Flap on Subemergency Abstract： Objective To conclude the experience of application of sural neurovenofasciocutaneous island flaps for recotruction of foot and ankle soft tissue defects. Methods Thirtytwo patients with soft tissue defects on malleolus and foot were resurfaced with sural neurovenofasciocutaneous island flap from May 2000 to July 2006 on subemergency， which mea five to seven days after the injuries. Preoperative data， postoperative results and complicatio were recorded. The patients were followed up in out patient′s department. Results All patients were followedup for one to seventy. Three months average six and a half months. All flaps survived completely except marginal necrosis was seen in one and infection in another. There was no coiderable morbidity on donor site for all patients. Conclusion Sural neurovenofasciocutaneous island flap is effective to repair the small and medium soft tissue defects on malleolus and foot. The surgical technique is simple and easy to succeed. The procedure should be performed on subemergency. Key words： delated； sural neurovenofasciocutaneous island flap； soft tissue defect； surgical treatment 我科从2000年5月至2006年7月运用小隐静脉腓肠神经岛状皮瓣修复足踝部软组织缺损患者32 例，现报告如下。 1 一般资料 患者共32 例，男23 例，女9 例。其中车祸伤20 例，机器轧伤6 例，石块砸伤3 例，钢缆绞伤2 例，高处坠落伤1 例。所有患者均经急诊手术清创治疗，延期手术时踝部软组织缺损，骨骼肌腱外露患者25 例(其中20 例伴有踝部骨折脱位或小腿下段的骨折，均于急诊时复位并简单固定)，足背缺损5 例(其中4 例伴有足部骨折或脱位，于急诊时已作相应处理)，足跟缺损2 例(存在骨外露，无骨折) 2 手术时机及手术方法 手术时机 选择行延期手术，根据患者的实际情况，一般在急诊第一次手术后5～7 d，待患者全身情况好转，局部软组织条件成熟，患者心理生理准备充分时进行。 手术方法 患者取连续硬膜外麻醉。受区处清创，将坏死皮肤切除，使创面皮缘出现正常活跃渗血为止。根据受区创面大小形状设计以小隐静脉和腓肠神经为轴心蒂的局部岛状皮瓣，皮蒂的旋转点设计于外踝上2