组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2025, Vol. 21 ›› Issue (3): 220-.

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长血管蒂腓动脉穿支皮瓣修复膝关节下部皮肤软组织缺损的临床应用

  

  • 出版日期:2025-06-02 发布日期:2025-07-01

Clinical application of the long vascular pedicle peroneal artery perforator flap in repairing soft tissue defects of the lower knee joint

  • Online:2025-06-02 Published:2025-07-01

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摘要： 目的 评价长血管蒂腓动脉穿支皮瓣修复膝关节下部皮肤软组织缺损的临床疗效。方法 回顾分析2021年 1月至2023年12月期间我科收治的15例采用长血管蒂腓动脉穿支皮瓣修复膝关节下部创面的患者临床资料。其中， 男10例，女5例；年龄18~67岁；皮瓣切取面积18~40 cm2 ，供瓣区直接缝合10例，植皮修复5例。记录手术时长，术中出 血，愈合时间，皮瓣、皮片成活情况，术后并发症等，末次随访时使用英国医学研究会感觉功能评定标准（BMRC）、下肢功能 评分量表（LEFS）进行评价。结果 所有患者术后随访（20.6±6.6）个月，10例皮瓣血管蒂为全段穿支，5例为穿支加部分腓 动脉主干，血管蒂平均长（7.8±3.8） cm。15例皮瓣及4例供区植皮全部Ⅰ期成活，1例供区植皮皮片局部坏死经换药后痊 愈。末次随访时所有皮瓣质地柔软、血运良好，BMRC感觉评定S2级3例，S3级10例，S4级2例，两点间感觉平均（12.1± 4.5） mm，术区无瘢痕增生、挛缩的发生，患肢行走功能正常，LEFS评分平均（72.8±4.7）分。结论 长血管蒂腓动脉穿支皮 瓣修复膝关节下部皮肤软组织缺损不仅手术操作相对简单易行，且修复后下肢功能恢复好，局部外观无畸形，患者满意 度高，具有较好的临床疗效。

关键词: 长血管蒂, &emsp, 腓动脉皮瓣, &emsp, 创面修复, &emsp, 膝关节

Abstract: Objective To evaluate the clinical efficacy of long vascular pedicle peroneal artery perforator flap in repairing soft tissue defects of the lower knee joint. Methods Clinical data of 15 patients with lower knee joint wounds repaired by long vascular pedicle peroneal artery perforator flaps from January 2021 to December 2023 were retrospectively analyzed， including 10 males and 5 females， aged 18-67 years old. The flap harvest area ranged from 18 cm² to 40 cm². The donor area was directly sutured in 10 cases， and skin grafting was performed in 5 cases. The duration of the surgery， intraoperative bleeding， healing time， survival of flaps and skin grafts， postoperative complications， etc.， were recorded. The final followup evaluation was conducted using the British Medical Research Council （BMRC） sensory function assessment criteria and the Lower Extremity Functional Scale （LEFS）. Results All patients received an average follow-up of （20.6±6.6） months postoperatively. In 10 cases， the vascular pedicle of the flap was a full segment perforator， and in 5 cases， it was a full segment perforator plus part of the peroneal artery trunk. The pedicle length averaged（ 7.8±3.8） cm. All 15 cases of skin flap and 4 cases of donor area skin graft survived in the first stage， and 1 case of local necrosis of donor area skin graft was cured after dressing change. At the last follow-up， all flaps were soft in texture and had good blood circulation. The BMRC sensory assessment showed S2 level in 3 cases， S3 level in 10 cases， and S4 level in 2 cases， with an average two-point discrimination of（ 12.1±4.5） mm. There were no complications such as scar hyperplasia or contracture in the surgical area， and the walking function of the affected limb was normal， with an average LEFS score of （72.8±4.7） points. Conclusion The repair of skin and soft tissue defects in the lower part of the knee joint using a long vascular pedicle peroneal artery perforator flap is not only relatively simple and easy to perform， but also results in good recovery of lower limb function， with no deformities in the local appearance and high patient satisfaction， demonstrating good clinical efficacy.

Key words: Long vascular pedicle, &emsp, Peroneal artery flap, &emsp, Wound repair, &emsp, Knee joint