Objective To explore therapeutic effect of free anterolateral thigh perforator flap transfer in repairing soft tissue defect of forefoot,emphasize the high quality anastomosis of lateral femoral cutaneous nerve and recipient nerve,and discuss the surgical method and application experience.Methods A total of 9 cases of forefoot soft tissue defects were treated in our department from January 2020 to January 2022,with the defect area of 8.0 cm×4.0 cm～14.0 cm×8.0 cm.High-frequency Doppler ultrasound was used to locate the location of the vascular perforator before surgery,and the flap shape and size were designed according to the defect area.Free anterolateral femoral perforator flap was removed for transfer and repair.The flap area was 9.0 cm×5.0 cm～15.0 cm ×9.0 cm.During incision,the lateral femoral cutaneous nerve was be separated and anastomosed with the recipient nerve in high quality.The donor skin was sutured directly or closed by free skin grafting.Results All 9 cases of flaps survived,1 cases had vascular crisis,which improved after timely treatment,and the donor area healed in stage I.The patients were followed up for 12-23 months,with an average of 15.2 months.According to the British Medical Research Council(BMRC)sensory function assessment criteria,sensory recovery:S3+6 cases,S3 2 cases,S2 1 case.The appearance of the flap was partly bloated,the texture was soft,no foot ulcer occurred,and the sensory function of the skin flap recovered well.Conclusion Emphasizing the anastomosis of lateral femoral cutaneous nerve with the recipient nerve and applying free anterolateral femoral perforator flap transfer to repair soft tissue defect of forefoot can obtain better protective sensory recovery,obtain good curative effect,and is not difficult to operate,which is suitable for clinical promotion.
维普
万方数据