摘要目的 总结游离前锯肌肌肉筋膜瓣桥式移植修复小腿软组织缺损的临床应用经验.方法 2006年9月至2009年1月应用游离前锯肌肌肉筋膜瓣桥式移植修复7例小腿软组织缺损.肌肉筋膜瓣切取连带肩胛下与旋肩胛血管,血管蒂呈T形,与健侧小腿胫后动脉两断端行端端吻合,肌肉筋膜瓣及其血管蒂用中厚皮片网状移植覆盖.结果 7例肌肉筋膜瓣全部成活.术后经过顺利,取得了较满意的效果.随访9～42个月,供区无明显功能障碍,且供、受区外形均较好.健侧小腿经临床观察与多普勒超声血流探测仪检查,胫后动脉通畅.结论 该术式适宜修复小腿软组织缺损仅有1条主要动脉者,不损伤健侧小腿胫后动脉,且对供区的损伤也较轻.

abstractsObjective To investigate the application of free anterior serratus musculo-fascial flap in bridge style for the soft tissue defect at leg.Methods From Sept.2006 to Jan.2009,the free anterior serratus musculo-fascial flaps were used in bridge style in 7 cases with soft tissue defects at legs.The anterior serratus musculo-fascial flaps were elevated with subscapular and circumflex scapular vessels forming a T-shaped vascular pedicles.The T-shaped pedicle was end-to-end anastomosed with the two ends of the posterior tibial artery at the healthy leg.The musculo-fascial flap and its pedicle were covered with skin graft.Results All the 7 flaps survived completely with satisfactory result.The patients were followed up for 9-42 months with good functional and esthetic result both in donor site and recipient site.The patency of posterior tibial artery was demonstrated by clinical and Doppler examination.Conclusions This technique is particularly useful in leg reconstructive surgery when only one vessel remains.The patency of the posterior tibial artery at the healthy leg is preserved and the morbidity in donor site is minimal.