摘要目的 分析腓肠内侧动脉穿支皮瓣的特点,探讨其修复前足背侧中小型创面的可行性.方法2012年3月至2015年12月,采用腓肠内侧动脉穿支皮瓣游离移植修复前足背侧中小型创面12例,其中男7例,女5例,年龄19～49岁,平均32岁;受伤原因:压砸伤6例,电锯伤5例,热压伤1例.本组创面面积4.0 cm×3.0 cm～4.0 cm×6.0 cm,切取皮瓣面积为4.0 cm×5.0 cm～5.0 cm×7.0 cm,12例皮瓣供区均直接缝合.定期进行随访.结果术后皮瓣全部成活,其中11例顺利成活,l例术后出现静脉危象,经积极探查后皮瓣成活.术后5～24个月随访,皮瓣色泽与周围正常皮肤相似,患足行走功能恢复良好.小腿供区仅存留较小的线状瘢痕.结论腓肠内侧动脉穿支皮瓣血管解剖相对恒定、血供可靠,手术操作可在止血带下同一术野完成,皮瓣切取较简单,局部破坏小,血管蒂长,皮下脂肪含量较少,应用其修复前足背侧创面,可获得满意效果.

abstractsObjective To analyze the characteristics of medial sural artery perforator (MSAP) flap, and to ex-plore the practicality of repair of small and medium-sized defects of dorsum pedis with the flap. Methods Between March, 2012 to December, 2015, 12 patients with variable defects of 4.0 cm×3.0 cm to 4.0 cm×6.0 cm underwent MSAP flap reconstruction. There were 7 males and 5 females, aged from 19 to 49 years (mean, 32 years). The disease causes were crush injury in 6 cases, machine saw injury in 5 cases, and hot crush injury in 1 case. The size of flaps ranged from 4.0 cm × 5.0 cm to 5.0 cm×7.0 cm. All of the donor site was sutured directly. Postoperative follow up was done termly. Results All 12 flaps survived. The flap was similar to the surrounding normal skin, and all patients returned to ambulation. Eleven cases survived without a hitch, the other 1 of venous congestion was salvaged by venous thrombectomy and reanastomosis. Fol-lowed-up 5-24 months postoperative, the color of the flap was similar to the surrounding skin. All patients recovered walk-ing and shoe wearing function. The calf residual linear scar. Conclusion The MSAP flap provides thin soft tissue cover-age, enabling good functional recovery after defect reconstruction dorsum of forefoot, show the evident advantages.