Abstract：
Foot injuries, particularly degloving injuries, can lead to segmental loss of neurovascular structures in the toes, making simultaneous reconstruction of both the foot and toes challenging. This case report presents a technique using the superficial circumflex iliac artery perforator (SCIP) flap for immediate reconstruction of the dorsal foot and revascularization of multiple toes. A 28-year-old man suffered a degloving injury on the dorsum of his foot resulting in a 9 × 6cm skin defect, open fracture dislocations, exposure of tendons, and neurovascular injury, which included a 6-7.5 cm segmental defect of the vessels supplying the first, second, and third toes leaving all three toes ischemic. Immediate reconstruction was performed by harvesting a 12.5 × 5cm SCIP flap including both the superficial and deep branches and incorporating the superficial inferior epigastric vein (SIEV). The SCIP deep branch was used to revascularize the third and second toes and the SIEV vein graft used for the first toe. The patient recovered well, no complications were observed at the 2-year follow-up, preserving all three toes and regaining mobility. The use of the SCIP flap as a flow-through flap provides thin skin flap cover, good vessel caliber size match with digital vessels and reduces the need for vein grafts from distant sites improving surgical efficiency. These attributes make the flow-through interposition SCIP flap an excellent choice for reconstructing foot defects and revascularizing toes. We report this case to demonstrate the utility of the SCIP flap in immediate soft tissue cover and digit revascularization.
摘要：
脚部受伤,尤其是脱套伤，会导致脚趾神经血管结构的节段性丢失，同时重建脚和脚趾具有挑战性。此病例报告介绍了一种使用旋浅动脉穿支（SCIP）皮瓣立即重建足背和多个脚趾血运重建的技术。一名二十八岁男子脚背脱套伤,导致皮肤缺损9×6厘米,开放性骨折脱位,肌腱的暴露，和神经血管损伤，其中包括供应第一血管的6-7.5厘米节段性缺陷，第二,第三个脚趾让所有三个脚趾缺血。通过收获12.5×5cm的SCIP皮瓣进行即时重建，该皮瓣包括浅表和深支，并合并浅表下胃静脉（SIEV）。SCIP深支用于第三和第二脚趾的血运重建，SIEV静脉移植物用于第一脚趾。病人恢复得很好,在2年的随访中没有观察到并发症,保留所有三个脚趾并恢复活动能力。使用SCIP襟翼作为流通式襟翼提供薄的蒙皮襟翼覆盖,良好的血管口径大小与数字血管相匹配，减少了对远处静脉移植的需要，提高了手术效率。这些属性使流通式介入SCIP皮瓣成为重建足部缺损和脚趾血管重建的绝佳选择。我们报告此病例以证明SCIP皮瓣在即时软组织覆盖和手指血运重建中的实用性。
