CAJ | 학술논문

目的探讨逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损的疗效.方法采用50侧经动脉灌注红色乳胶的成人足标本,解剖观测内踝前动脉、跗内侧动脉的前后分支、拇趾底内侧动脉浅支、足底内侧动脉浅支和隐神经营养血管及其与邻近动脉的吻合关系,并根据解剖结果设计逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损.结果解剖结果表明,足拇展肌表面的动脉网,足拇展肌上缘动脉弓在隐神经周围、足背和足底内侧形成血管网,构成逆行足内侧隐神经营养血管皮瓣的血供基础.2006年10月至2011年10月,临床应用该皮瓣11例,皮瓣切取范围2.5 cm×3.5 cm～7.5 cm×8.5 cm,供区以全厚皮片移植覆盖.术后所有皮瓣均成活,随访6～18个月,平均10个月,皮瓣色泽、质地、外形良好,患足行走正常,皮瓣及供区无溃疡发生.结论应用逆行足内侧隐神经营养血管皮瓣修复足前部皮肤缺损,血供可靠,操作简单,创伤小,是修复足前部皮肤缺损的理想皮瓣供区.
목적 탐토역행족내측은신경영양혈관피판수복족전부피부결손적료효.방법 채용50측경동맥관주홍색유효적성인족표본,해부관측내과전동맥、부내측동맥적전후분지、무지저내측동맥천지、족저내측동맥천지화은신경영양혈관급기여린근동맥적문합관계,병근거해부결과설계역행족내측은신경영양혈관피판수복족전부피부결손.결과 해부결과표명,족무전기표면적동맥망,족무전기상연동맥궁재은신경주위、족배화족저내측형성혈관망,구성역행족내측은신경영양혈관피판적혈공기출.2006년10월지2011년10월,림상응용해피판11례,피판절취범위2.5 cm×3.5 cm～7.5 cm×8.5 cm,공구이전후피편이식복개.술후소유피판균성활,수방6～18개월,평균10개월,피판색택、질지、외형량호,환족행주정상,피판급공구무궤양발생.결론 응용역행족내측은신경영양혈관피판수복족전부피부결손,혈공가고,조작간단,창상소,시수복족전부피부결손적이상피판공구.
Objective To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects of forefoot.Methods In the anatomic study,50 cadaveric feet were injected with red latex and the anastomosis,distribution and external diameters of medialtarsal artery,medial anterior malleolus artery,medial plantar artery,the superficial branch of the medial basal hallucal artery and saphenousnerve nutritional vessels were observed.Based on anatomic research results,we designed the reverse saphenous nerve neurocutaneous flaps for repairing skin defects of forefoot.Results The blood supply of reverse saphenous nerve neurocutaneous flaps were based on the vasoganglion,which consist of arterial arch at the superior border of abductor hallucis and arterial network on the surface of abductor hallucis around the saphenous nerve and medial pedis flap.From Oct.2006 to Oct.2011,the reverse saphenous nerve neurocutaneous flaps were used to repair skin defects of forefoot in 11 cases.The flap size ranged from 2.5 cm ×3.5 cm to 7.5 cm ×8.5 cm.The wounds at donor site were covered with fullthickness skin graft.All flaps survived completely with no ulcer at the donor site.11 cases were followed up for 6 to 18 months(mean,10 months).The skin color and texture were satisfactory.The patients could walk very well.Conclusions It is reliable to repair the skin defects of forefoot with reverse saphenous nerve neurocutaneous flaps.It is easily performed with less morbidity.This flap should be considered as a preferential way to reconstruct skin defects of forefoot.