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目的探讨腓肠神经营养血管皮瓣的血供特点和临床应用的可行性。方法用6只成人下肢标本,对腓肠神经营养血管的来源、行径、分布及其与知名血管的吻合关系进行解剖观察。设计了腓肠神经营养血管皮瓣应用于临床修复足踝部、小腿下1/3段软组织缺损3例。结果腓肠浅动脉与腓肠神经伴行,在腓肠神经旁形成纵向血管链,除营养神经外,发出众多皮支与深筋膜血管网、皮下血管网广泛吻合营养皮肤,在外踝上5 cm与腓动脉穿支有吻合。临床应用3例全部成活,外观满意。结论该皮瓣血供可靠,切取简单安全,可有效地修复足踝部、小腿下1/3段软组织缺损。
Objective To investigate the characteristics of blood supply of sural neurovascular flap and the feasibility of clinical application. Methods Six adult lower extremity specimens were used to dissect the origin, course and distribution of nutrient vessels in the sural nerve and their anastomosis relationship with well-known vessels. Sural neurocutaneous vascular flap was designed for the clinical repair of the ankle and lower third of the lower leg soft tissue defects in 3 cases. Results Sural superficial arteries and sural nerve accompanied by the formation of vertical vascular chain in the sural nerve, in addition to the nutritional nerve, issued a large number of skin branches and deep fascia vascular network, subcutaneous vascular network wide consistent nutrient skin, the lateral malleolus 5 cm and perforation of peroneal artery anastomosis. Three cases of clinical application all survived, the appearance of satisfaction. Conclusion The flap is reliable, cut simple and safe, and can effectively repair soft tissue defects in the lower third of the foot, ankle and lower leg.