- 期刊
The Pedicled Posterior Tibial Artery Perforator Flap for Lower Leg and Foot Reconstruction
運用帶莖後脛骨動脈穿通枝皮瓣重建遠端小腿和足的缺損
摘要
背景：遠端小腿和足的軟組織缺損仍然是一個困難的課題，往往需要自由皮瓣移植來做重建。隨著對穿通枝皮瓣的瞭解，我們可以運用下肢的帶莖穿通枝皮瓣做局部轉移，重建此處的軟組織。目的及目標：運用帶莖後脛骨動脈穿通枝皮瓣重建遠端小腿和足的缺損，共八例的經驗。材料及方法：從2008年至2011年，八名患者接受帶莖後脛骨動脈穿通枝皮瓣重建小腿和足的軟組織缺損。傷口位於脛骨前方（n = 2），脛骨遠端（n = 3），內踝骨（n = 2），和阿基里斯腱處（n = 1）。七名患者的受傷機轉為高能量創傷，六名有脛骨骨折，兩名併發慢性骨髓炎。結果：皮瓣的寬度為4至8公分，長度為10至24公分。六例採用螺旋式皮瓣設計，兩例採半島式設計。所有皮瓣都存活。三例產生局部皮瓣壞死，兩例需接受清創。一名患者因持續骨髓炎，需做自由皮瓣移植。結論：帶莖後脛骨動脈穿通枝皮瓣可以提供薄且柔軟的組織，作為小腿與足軟組織重建的另一選擇。
關鍵字
無資料並列摘要
Background:Reconstruction of soft tissue defects in the lower leg and foot remains challenging. The difficult wounds often necessitate microsurgical free tissue transfers in these areas. With an increased understanding of the perforator flap concept, the pedicled perforator flap in the lower extremity has become a valuable alternative for soft-tissue reconstruction.Aim and Objectives:Here we present our experiences using pedicled posterior tibial artery perforator flaps for coverage of defects in the lower leg and foot.Materials and Methods:From 2008 to 2011, eight pedicled posterior tibial artery perforator flaps were applied to provide coverage for the lower leg and foot defects. The defects were at the pretibial area (n=2), distal tibial area (n=3), medial malleolar area (n=2), and Achilles' tendon (n=1). High-energy injuries occurred in seven patients, in which six were accompanied with tibial fractures, and two developed osteomyelitis.Results:The flap size ranged from 4 to 8 cm wide and 10 to 24 cm long. Two designs of the flaps were employed, including six propeller flaps and two peninsular flaps. All flaps survived. But partial flap loss was encountered in three cases, two of which needed subsequent debridement. One sustained from chronic osteomyelitis and required further flap coverage.Conclusion:The pedicled posterior tibial artery perforator flaps, which provide adequate thin and pliable soft tissue coverage, could be one of the options for reconstruction of the lower leg and foot defects.
延伸閱讀
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