Experience with the Distally Based Sural Neurocutaneous Flap for Ankle and Heel Wounds: 遠端蒂腓腸神經營養血管皮瓣應用在足踝部和腳後跟的傷口的經驗

Background/PurposeSoft tissue loss over the ankle and heel is a challenging issue for reconstructive surgeons. The aim of this study is to present the technique of using sural neurocutaneous flap and analyse the results.MethodsFrom 2002 to 2014, 15 cases of sural flap were performed in the Department of Orthopaedics and Traumatology of United Christian Hospital, Hong Kong. All cases were handled by two hand surgeons. The outcomes and complications were reviewed retrospectively.ResultsThe aetiology included trauma (6 cases), neoplasm (4 cases), Achilles tendon repair wound complication (3 cases) and ulcer (2 cases). The age of patients ranged from 21 years to 82 years (average, 61.9 years). The size ranged from 12 cm2 to 99 cm2. The mean follow-up period was 20 months. Eleven flaps healed successfully without significant complications.ConclusionSural neurocutaneous flap is a reliable flap design with constant vascular anatomy. There is minimal donor site morbidity, and no major vessels are sacrificed. It provides a durable, pain-free, functionally and aesthetically satisfying coverage for ankle and heel wounds.

中 文 摘 要背景重建在足踝部和腳後跟的軟組織損失,對外科醫生來說,是一個十分富挑戰性的難題。本研究的目的是研究遠端蒂腓腸神經營養血管皮瓣的應用和分析術後結果。方法從2002年到2014年,在香港基督教聯合醫院進行了15例遠端蒂腓腸神經營養血管皮瓣手術。所有手術由兩位手外科醫生主理。我們回顧了手術結果和併發症。結果15例的病因包括外傷(6),腫瘤(4),跟腱修復手術傷口併發症(3)和潰瘍(2)。病人年齡介乎21至82歲,平均61.9歲。傷口大小介乎12至 99平方厘米。平均隨訪期為20個月。當中十一例皮瓣癒合成功,沒有顯著的併發症。結論蒂腓腸神經營養血管皮瓣是一種設計可靠而帶有固定血管解剖位置的皮瓣。它的供皮位創傷小,也不需要有大血管被犧牲。它為足踝部和腳後跟傷口提供了一個耐用,無痛苦,功能上和美學上都令人滿意的覆蓋方案。