小腿踝上穿支蒂螺旋桨皮瓣修复足底黑色素瘤切除后创面_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

许育健 ¹ , 徐永清 ² , 赵万秋 ² , 杨曦 ² , 张旭林 ² , 段家章 ² , 吴欢 ² , 袁礼波 ² ,  何晓清 ²

1. ;
2. ;

Corresponding author：

何晓清, Email: hxq00@foxmail.com

Keywords：

穿支蒂螺旋桨皮瓣; 小腿穿支血管; 黑色素瘤; 足底; 创面修复

DOI：

10.7507/1002-1892.201905063

Video：

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目的总结小腿踝上穿支蒂螺旋桨皮瓣修复足底黑色素瘤切除后创面的疗效。方法 2016 年 4 月—2018 年 6 月，收治 6 例足底黑色素瘤患者。男 2 例，女 4 例；年龄 32～53 岁，平均 36 岁。病程 1～320 个月，中位病程 58 个月。肿瘤扩大切除后，遗留创面范围为 5.8 cm×4.5 cm～10.6 cm×8.7 cm，切取小腿踝上穿支蒂螺旋桨皮瓣修复。皮瓣旋转后大桨无张力修复创面，小桨修复供区创面；皮瓣切取范围为 8.5 cm×6.8 cm～12.0 cm×10.5 cm。供区经皮瓣修复后 4 例直接拉拢缝合、2 例游离植皮修复。结果术后除 1 例皮瓣部分表皮坏死，其余皮瓣及植皮均顺利成活，创面及供区切口均Ⅰ期愈合。患者均获随访，随访时间 3～24 个月，平均 18 个月。除 3 例皮瓣臃肿行二期修整外，其余皮瓣外形良好，色泽、质地及弹性佳；足底浅感觉不同程度恢复。末次随访时，按美国矫形足踝协会（AOFAS）评分，获优 4 例、良 1 例、可 1 例，优良率为 83.3%。随访期间无肿瘤复发。结论小腿穿支蒂螺旋桨皮瓣质地与足底组织相似，皮瓣易于旋转，无需牺牲主要血管，适用于修复足底黑色素瘤切除后创面。

Citation： 许育健, 徐永清, 赵万秋, 杨曦, 张旭林, 段家章, 吴欢, 袁礼波, 何晓清. 小腿踝上穿支蒂螺旋桨皮瓣修复足底黑色素瘤切除后创面. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(3): 413-414. doi: 10.7507/1002-1892.201905063 Copy

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1. Memis A, Ozturk S, Mutluoglu M, et al. Self-treatment of foot ulcers as a risk factor for delayed diagnosis of acral melanoma. Int Wound J, 2016, 13(5): 1079.
2. Mendieta M, Cabrera R, Siu A, et al. Perforator propeller flaps for the coverage of middle and distal leg soft-tissue defects. Plast Reconstr Surg Glob Open, 2018, 6(5): e1759.
3. Wade RG, Watford J, Wormald JCR, et al. Perforator mapping reduces the operative time of DIEP flap breast reconstruction: A systematic review and meta-analysis of preoperative ultrasound, computed tomography and magnetic resonance angiography. J Plast Reconstr Aesthet Surg, 2018, 71(4): 468-477.
4. Russell-Jones R. A brighter future for melanoma. Br J Dermatol, 2019, 181(4): 874.
5. 朱珊, 刘元波, 于胜吉, 等. 穿支螺旋桨皮瓣在四肢软组织恶性肿瘤切除后创面修复中的临床应用. 中国修复重建外科杂志, 2016, 30(1): 82-86.
6. Patel PK, Shikha T, Nitin K. Medial plantar artery perforator flap for reconstruction of the soft tissue defect of heel melanoma. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2009, 6(2): 1661-1665.
7. 章一新. 穿支血管的术前影像学导航技术. 中华显微外科杂志, 2012, 35(6): 441-443.

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小腿踝上穿支蒂螺旋桨皮瓣修复足底黑色素瘤切除后创面

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