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目的探讨腘窝中间动脉蒂混合供血皮瓣的血供特点及修复儿童腘窝瘢痕挛缩松解后创面的可行性。方法 2008年1月-2010年10月,对6例腘窝瘢痕挛缩患儿行瘢痕松解、腘窝中间动脉蒂混合供血皮瓣移位修复。男2例,女4例;年龄2岁2个月～10岁。均为热水烫伤。腘窝瘢痕挛缩松解后创面范围5 cm×4 cm～10 cm×8 cm,皮瓣切取范围6 cm×4 cm～11 cm×9 cm。供区直接缝合1例,游离植皮5例。结果术后6例患儿皮瓣完全成活,无血管危象或皮瓣坏死发生。供、受区切口均Ⅰ期愈合,供区植皮均成活。术后患儿均获随访,随访时间12～24个月,皮瓣色泽、质地、外形良好。1例患儿术后6个月腘窝手术切口出现较厚增生性瘢痕,膝关节活动范围0～175°,随访15个月无明显变化;余5例膝关节活动范围0～180°,无跛行。结论腘窝中间动脉蒂混合供血皮瓣血供可靠,手术操作简便,修复儿童腘窝瘢痕挛缩松解后创面效果理想。
Objective To investigate the blood supply characteristics of the mixed donor flap of the popliteal artery and the feasibility of repairing the wound after the contracture of the contracture of the popliteal fossa in children. Methods From January 2008 to October 2010, 6 cases of cicatricial contracture of scar contracture were treated with scar release and the transposition of mixed blood supply flap of the popliteal artery in the popliteal fossa. 2 males and 4 females; aged 2 years and 2 months to 10 years old. All hot water burns. The size of the wound was 5 cm × 4 cm ~ 10 cm × 8 cm and the flap was cut from 6 cm × 4 cm to 11 cm × 9 cm. For the area of direct suture in 1 case, 5 cases of free skin graft. Results The flaps of 6 children survived completely without vascular crisis or skin flap necrosis. For the incision by the area were first-stage healing, for the skin graft are alive. All patients were followed up for 12-24 months. The flap color, texture and appearance were good. One case had hypertrophic scars at 6 months postoperatively. The range of knee joint activities ranged from 0 to 175 °. There was no significant change in the follow-up period of 15 months. The remaining 5 cases ranged from 0 to 180 ° in knee joint motion, limp. CONCLUSION: The blood supply of mixed blood supply flap in the popliteal fossa peduncle is reliable, and the operation is simple and convenient. The repaired wounds in children with popliteal scar contracture are ideal.