Objective To explore the efficacy of the transplantation of combined free bilateral anterolateral thigh perforator flaps in repairing special wounds of limbs.Methods A retrospective analysis was performed on 32 patients in our hospital from May 2018 to December 2022 who underwent the transplantation of combined free bilateral anterolateral thigh perforator flaps to repair special wounds of limbs.The combined flaps were divided into main flaps and sub-flaps.The blood circulation of the flaps was reconstructed by connecting the pedicle artery and accompanying vein of the subflap to the distal or larger muscular branch of the descending branch of the lateral circumflex femoral artery carried by the main flap.The sensation of the flaps was reconstructed by using the lateral femoral cutaneous nerve,and the donor area was sutured directly to evaluate the postoperative wound repair effect.Results The flap survived successfully in 28 cases and the wound healed in stage Ⅰ.In 1 case,the subflap was necrosis,the main flap survived,and the second stage of free skin grafting successfully repaired the wound.The skin scab of tension blister appeared at the distal end of the subflap in 1 case,which healed at stage Ⅱ after bleeding at the edge of the changed flap.2 patients survived after venous crisis investigation.All 32 patients were followed up for 3 to 36 months,with an average of 17.5 months.The skin flap recovered the pain and warmth sensation 2 months after the operation and the touch sensation 3 months after the operation.The skin flap was soft in texture and satisfactory in appearance at the last follow-up.Conclusion The combined bilateral anterolateral thigh perforator flaps to repair irregular and large wounds of limbs shows its great advantages.The sensory reconstruction of flaps made by the lateral femoral skin nerve and the direct suture of the donor areas ensure a better clinical effect.
维普
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