摘要目的 探讨比目鱼肌肌皮穿支应用解剖特点及比目鱼肌穿支皮瓣游离移植在临床中的应用. 方法 6例12侧下肢标本经灌注后解剖观测小腿外侧穿支特点及比目鱼肌皮穿支血管的走行分布特点.自2002年7月至2010年10月,应用比目鱼肌肌皮穿支为蒂的比目鱼肌穿支皮瓣游离移植修复体表皮肤软组织缺损14例,其中前足及足背侧皮肤组织缺损8例,踝前部组织缺损2例,手部缺损2例,肘部缺损2例.皮瓣面积5 cm×6cm～12cm×20cm. 结果 小腿外侧中上段恒定存在比目鱼肌皮穿支,多在腓骨头下5～ 24 cm,位置恒定.肌皮穿支外径在动脉起始部为(1.08±0.12)mm,静脉外径(1.20±0.32)mm.14例比目鱼肌肌皮穿支供血的穿支蒂皮瓣均成活,经6～12个月(平均8个月)随访,皮瓣质地优良,外观及功能恢复良好. 结论 直接肌支供血的比目鱼肌穿支皮瓣游离移植避免了暴露腓动脉,且切取简便,吻合管径适宜,是修复组织缺损的一种理想选择.

abstractsObjective To study the anatomy of the soleus muscle perforator flap and its clinical application.Methods In 6 cadavers specimen with 12 lower limbs,the cutaneous branches and soleus muscle perforator artery were dissected and their measurements were recorded.Fourteen patients with skin and soft tissue defects from July 2002 to October 2010 were repaired by the soleus muscle perforator flap.Of the 14 patients,eight for dorsal and anterior defects of foot,two for anterior defects of malleolus,two for hand defects,two for elbow defects.The size of the flaps was 5 cm × 6 cm - 12 cm × 20 cm.Flap success rates and postoperative course were evaluated. Results The soleus musclocutaneous perforators mostly appeared within 5 - 24 cm length below the head of fibula.The diameter of the artery cutaneous perforator was( 1.08 ±0.22)mm,vena concomitants was (1.20 ± 0.32)mm.All flaps were survived completely and the wounds got primary closure in 14 cases.The flaps were not overstaffed,and their shape,texture and color were similar to normal.All of the 14 cases were evaluated as satisfactory after 6 months to 12 months follow-up. Conclusion The free soleus muscle perforator flap is an ideal flap for repairing skin and soft tissue defects with the merit of simple procedure,minimal trauma and more physiological circulation established.