首页|含斜支股前外侧游离皮瓣的设计及应用

含斜支股前外侧游离皮瓣的设计及应用

DESIGN AND APPLICATION OF ANTEROLATERAL THIGH FREE FLAP WITH OBLIQUE BRANCH

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目的 探讨含斜支股前外侧游离皮瓣的设计及其临床应用可行性. 方法 2009年6月-2013年2月,收治12例交通事故伤所致下肢创面患者.男7例,女5例;年龄8~42岁,中位年龄32岁.缺损部位:小腿下端2例,踝周并足背4例,足背5例,足远端1例.创面均伴肌腱及骨组织外露,创面范围15cm×7cm~27cm× 12cm.患者受伤至手术时间1~7 d,平均3.7 d.采用斜支作为供血血管的股前外侧游离皮瓣7例,采用含斜支及降支的股前外侧游离皮瓣5例.皮瓣切取范围17 cm×9 cm~30 cm×15 cm.供区直接拉拢缝合3例,植皮修复9例. 结果 术后1例皮瓣远端部分坏死,经对症处理后愈合;其余皮瓣全部成活,创面Ⅰ期愈合.供区植皮成活,切口均Ⅰ期愈合.术后患者均获随访,随访时间10个月~2年,平均18个月.3例踝周并足背创面皮瓣臃肿,穿鞋困难,行二期修薄;其余皮瓣无臃肿,恢复保护性痛、温觉. 结论 采用含斜支股前外侧游离皮瓣修复下肢软组织缺损安全、有效.
Objective To investigate the feasibility of the anterolateral thigh free flap with the oblique branch in reconstructing the soft tissue defects of lower extremity.Methods Between June 2009 and February 2013,12 patients (including 7 males and 5 females) with soft tissue defects of lower extremity were treated with the anterolateral thigh free flap with the oblique branch,aged from 8 to 42 years (median,32 years).The locations of soft tissue defect were the dorsum of the foot in 5 cases,the ankle and foot in 4 cases,the lower leg in 2 cases,and the distal foot in 1 case.All defects were associated with exposure of tendon and bone.The size of the wound was from 15 cm × 7 cm to 27 cm × 12 cm.The interval of injury and operation was 1 to 7 days (mean,3.7 days).The anterolateral thigh flap was pedicled with only the oblique branch in 7 patients,and with the both descending branch and oblique branch in 5 patients,and the size of flap was from 17 cm × 9 cm to 30 cm × 15 cm.The donor sites were repaired by suture in 3 patients,and by skin graft in 9 patients.Results Distal skin flap necrosis occurred in 1 case,and was cured after dressing change and skin graft.The other flaps survived,and the donor site healed primarily.The follow-up time was from 10 months to 2 years (mean,18 months).Thinning operation was performed in 3 cases,and the other flaps recovered pain and warm sensation with good appearance.Conclusion It is a safe and effective method to reconstruct soft tissue defects of the lower extremity with the anterolateral thigh flap pedicled with the oblique branch.

Anterolateral thigh flapOblique branchSoft tissue defect of lower extremityWound repair

厉孟、蓝旭、甄平、高秋明、李志琳、高杰、杨巧巧、盖延林

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兰州军区兰州总医院全军骨科研究所 兰州,730050

股前外侧皮瓣 斜支血管 下肢软组织缺损 创面修复

全军“十二五”后勤科研计划面上项目

CLZ12J003

2014

中国修复重建外科杂志
中国康复医学会,四川大学华西医院

中国修复重建外科杂志

CSTPCDCSCD北大核心
影响因子:1.239
ISSN:1002-1892
年,卷(期):2014.28(7)
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