mbt laarzen The sural nerve island flap pedicled d

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The sural nerve distal to the clinical application of island flap

Clinical application of island characteristics of the skin defense. Methods: the distal sural neurovascular pedicle island skin defense repair small ~-Fff. , Lack of soft tissue ankle foot hoop Well Hao Yi bone marrow in 15 cases, followed up play against the Department of silent disease. Results: The maximum skin see a down debate 18 ∞ 1 × 8cm 2cm proximal skin edge necrosis, its Chennai plate debate all survived. Man varying degrees of bone marrow repair. Conclusion sural neurovascular island pedicled distal plate debate. Reliable blood supply area of a large, rotating large magnitude. Simple surgical cut. For the lower leg, ankle and foot soft tissue missing hoop Hao and osteomyelitis provides a good surgical technique, easy-to-session in the base hospitals. Keywords sural nerve island sun disk repair CLC R6812 Debate 1996 l2 months to May 1999, applied to distal sural neurovascular island flap pedicled l5 cases. 1 General Information 1.1 clinical data were treated in the lower leg,[link widoczny dla zalogowanych], ankle and foot soft tissue defects l5 cases. L3 male, female 2; age of 6 years to 53 years; which is followed by skin defect caused by traffic accident, exposed the calcaneus, osteomyelitis 5 cut out, heel region 2 cut out cancerous ulcer, post-traumatic ankle before the dorsal skin defects 4 cases. Size of the flaps 6cm ~ 7cm ~ 18cm × 8cm; pedicle length of 6 ~ 10cm. ,[link widoczny dla zalogowanych], 1.2 behind in the leg after surgical midline as the axis, 5cm above the lateral rotation point, accept the district need to design flaps. First cut flap proximal to find the small saphenous vein and sural nerve. Sometimes there are two sural nerve, be cut off with the flaps inside,[link widoczny dla zalogowanych], and then cut the flap, the lateral edge and remote, deep deep fascia, the number of suture needles fascia and subcutaneous flap to prevent skin Separation of deep fascia. Extension of the small saphenous vein and sural nerve to the distal extension of the line cut away so that nerves and veins adjacent to retain 2 ~ 3cm wide fascia, retrograde flap off. Donor site closure, or directly from the thigh to take fault in thickness skin graft coverage by area debridement, the flap through the subcutaneous tunnel directed to loose by area, to prevent torsion under pressure, relax tourniquet, after observing a good blood circulation flap , plane side flap with interrupted sutures by the district. 2 Results In addition to the maximum flap (18cm × 8crn) 2cm distal edge of skin necrosis healed after dressing change, the other flaps survived, I wound healing. . All medical records after 2 months to 2 years follow-up, flap, beautiful appearance, texture, abrasion resistance, no fistula formation. Repair varying degrees of osteomyelitis. 3 discussion sural nerve island flap distal vessels of the arterial blood supply of a complete system and the venous drainage system, blood supply, reliable, high survival rate. In addition to this group of patients with distal l largest cases of necrosis of 2 ∞, the other flaps survived, the effective control of osteomyelitis confirmed this. Wang and Ju ... 1, Hui Yang, Bin 【2J 24 cases were reported and no necrosis in 1 case. The sural nerve island flap pedicled distally has the following advantages: This flap is flap, the location is willing to light, surgical cut is simple, safe and reliable; long vascular pedicle flap, rotation rate of a large, covering an area of Big, beautiful appearance, not bloated. Fixes the lower leg, ankle, instep and heel proximal skin defect; without sacrificing extremity blood vessels, especially for the anterior tibial or posterior tibial artery has been injury, had little effect on the donor site; for the trauma caused by lower leg, ankle foot skin defects, early wound coverage of the emergency application of this flap can effectively prevent the exposed bone,[link widoczny dla zalogowanych], osteomyelitis and reduce the suffering of patients with multiple operations. Appropriate as a good surgical methods. Easily in the primary hospital. Disadvantages: feel free flap; the expense of the sural nerve; beyond the middle of the dorsal foot, plantar skin defects due to the axial blood supply can not exceed 16cm, difficult to repair; 5cm area of the lateral malleolus has been injury,[link widoczny dla zalogowanych], easy to damage the peroneal artery branch and the sural communicating branch between the superficial artery, this flap should not be applied.
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