DSA 联合多普勒超声辅助下胫后动脉穿支皮瓣修复小腿下段软组织缺损

组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (5): 446-.

DSA 联合多普勒超声辅助下胫后动脉穿支皮瓣修复小腿下段软组织缺损

出版日期:2023-10-09 发布日期:2023-10-31

Posterior tibial artery perforator flap assisted by DSA and Doppler ultrasound in the repair of skin and soft tissue defects in the lower leg

Online:2023-10-09 Published:2023-10-31

摘要/Abstract

摘要：

　目的　探索 DSA 联合多普勒超声辅助，设计胫后动脉穿支皮瓣，修复小腿下段软组织缺损的效果。

方法　自 2020 年 1 月至 2022 年 12 月，应用胫后动脉穿支皮瓣修复小腿下段软组织缺损共 5 例。术前应用 DSA 观察胫后动脉走行及穿支发出位置，选择优势穿支，多普勒超声确认优势穿支发出点，根据创面位置、面积设计皮瓣，并进行皮瓣移植。供瓣区植皮修复。结果　DSA 检查显示，5 例患者中 2 例小腿主干血管无损伤，3 例胫前动脉损伤、远端闭塞；5 例患者均可见胫后动脉穿支。5 例皮瓣及移植皮片均存活。术后随访 6~12 个月，所有患者受区外观满意，小腿及踝关节功能恢复。

结论　应用 DSA 观察胫后动脉穿支并选择优势穿支，联合多普勒超声定位，指导皮瓣设计，在修复小腿下段前侧和内侧创面中可取得良好效果。

关键词:

胫后动脉穿支皮瓣 , 　缺损 , 　小腿

Abstract:

Objective　To explore the effect of using DSA and Doppler ultrasound to design posterior tibial artery perforator

flap in the repair of soft tissue defect of the lower leg. Methods　From January 2020 to December 2022, 5 cases of lower leg

soft tissue defects were treated with a cutaneous branch of the posterior tibial artery flap. Preoperatively, digital subtraction an

giography (DSA) were used to confirm the course of the posterior tibial artery and the location of the penetrating branch, and the

dominant perforating branch was selected. Doppler ultrasound confirmed the location of the dominant perforating branch, and

the skin flap was designed based on the location and area of the wound, followed by skin flap transplantation. The donor flap area

was covered with skin grafting. Results　DSA examination showed that among the 5 patients, 2 had no damage to the main blood

vessels of the lower leg, and 3 had distal occlusion of the anterior tibial artery. All 5 patients showed perforating branches of the

posterior tibial artery. Five cases of flaps and grafted skin sheets survived. After 6-12 months of follow-up, the appearance of the

affected area was satisfactory, and the function of the leg and ankle joint recovered. Conclusion　Using DSA to observe the per

forating branch of posterior tibial artery and select the dominant perforating branch, combined with Doppler ultrasound to guide

the design of skin flap, good results can be obtained in the repair of the anterior and medial wounds of the lower leg.

Key words:

　Posterior tibial artery perforator flap, 　Defect, 　Lower leg

孙艺然, 陈勇, 王倩, 等.

DSA 联合多普勒超声辅助下胫后动脉穿支皮瓣修复小腿下段软组织缺损

[J]. 组织工程与重建外科杂志, 2023, 19(5): 446-.

SUN Yiran, CHEN Yong, WANG Qian, et al.

Posterior tibial artery perforator flap assisted by DSA and Doppler ultrasound in the repair of skin and soft tissue defects in the lower leg [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2023, 19(5): 446-.

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