CAJ | 학술논문

　　目的：对小腿外侧皮瓣的切取进行改进并总结其在足踝部创面修复中的经验和技巧。方法：2004年7月-2012年7月，应用小腿外侧皮瓣逆行转移修复足踝部创面19例，游离移植修复足踝部创面6例。其中8例将皮瓣内感觉神经与创面内感觉神经进行吻合。皮瓣面积最大27 cm×12 cm，最小9 cm×5 cm。结果：术后皮瓣全部成活。其中1例出现动脉危象，经拆除蒂部缝线，局部注射利多卡因后危象解除。1例出现静脉回流障碍，经拆除蒂部缝线、抗凝、换药处理后成活良好。本组病例随访时间6个月~2年，皮瓣外形满意，质地耐磨，足踝部功能恢复好。吻合神经的皮瓣恢复部分保护性感觉。结论：小腿外侧皮瓣血管解剖恒定，厚薄适中，供区隐蔽，是修复足踝部创面的有效方法。
　　목적：대소퇴외측피판적절취진행개진병총결기재족과부창면수복중적경험화기교。방법：2004년7월-2012년7월，응용소퇴외측피판역행전이수복족과부창면19례，유리이식수복족과부창면6례。기중8례장피판내감각신경여창면내감각신경진행문합。피판면적최대27 cm×12 cm，최소9 cm×5 cm。결과：술후피판전부성활。기중1례출현동맥위상，경탁제체부봉선，국부주사리다잡인후위상해제。1례출현정맥회류장애，경탁제체부봉선、항응、환약처리후성활량호。본조병례수방시간6개월~2년，피판외형만의，질지내마，족과부공능회복호。문합신경적피판회복부분보호성감각。결론：소퇴외측피판혈관해부항정，후박괄중，공구은폐，시수복족과부창면적유효방법。
Objective:To improve the method of ectocnemial skin flaps and summarize the experiences in the treatment of foot and ankle soft tissue defect. Method:From June 2002 to July 2012,25 patients suffered soft tissue defect in foot and ankle were repaired with ectocnemial skin flaps, including 19 cases with vascular pedicle and 6 cases free.The sensation nerves in the flap and the recipient site were anastomosed.The flap area ranged from 9 cm×5 cm to 27 cm×12 cm. Result:All flaps survived after operation. Insufficient arterial supply of flap occurred in 1 cases after operation,the pedicled incision sewing thread was removed and lidocain was injected around vascular pedicle,then the flap ischemia was released. Inadequate venous return and venous hyperemia occurred in 1 case and released after bloodletting.All patients were followed up from 6 months to 2 years.The flap were with good shape,wear-resistant and with good function.The protective sensation recovered in the cases in which the nerves were anastomosed.Conclusion:The ectocnemial skin flap is a reliable method to repair foot and ankle soft tissue defect with good shape and function.