游离串联皮瓣修复小腿大面积软组织缺损的临床应用  

Repairing a large area of soft tissue defects on leg with free chain-link flap

作　　者：董谢平[1] 周立义[1] 沈录峰[1] 柯雪蕾[1] 袁中平[1] 李振肃[1] 

机构地区：[1]江西省人民医院手外科,南昌330006

出　　处：《中华显微外科杂志》2009年第4期281-283,I0002,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨游离串联皮瓣在小腿大面积软组织缺损中的临床应用效果。方法本组12例病例均为小腿大面积软组织缺损伴有大面积骨外露，创面面积最大45cm×21cm．最小36cm×15cm。彻底清理创面后，采用显微外科技术，吻合血管串联两块游离皮瓣覆盖创面．其中小腿内侧皮瓣串联背阔肌皮瓣2例，股前外侧皮瓣串联腓肠肌内侧头肌皮瓣2例，股前外侧皮瓣串联背阔肌皮瓣8例。结果皮瓣全部存活，10例创面Ⅰ期愈合，2例经换药后愈合。随访3～18个月，下肢功能良好，皮瓣质地柔软，外形满意。结论游离串联皮瓣是治疗伴受区血管受限小腿大面积软组织缺损的较好方法。Objective To explore the clinical results of the series of free incorporating flaps repairing the leg which have a large area of soft tissue defects. Methods In 12 cases,there were not only a large area of soft tissue defects on leg , but also had a large area of bone exposure, the maximum of the wound was 45 cm× 21 cm, the minimum was 36 cm× 15 cm. After thorough debridement, using microsurgical techniques to incorporating two free flap by microvascular anastomosis, in those cases, there were 2 cases using medial leg skin flap combined latissimus dorsi flap and 2 cases using the flap that anterolateral thigh flap combined myocutaneous flap of gastroenemius medial head and 8 cases using the flap that the anterolateral thigh flap combined latissimus dorsi /lap. Results All flaps were survived, in which 10 were with primary healing and 2 were healed after dressing change. Follow-up 3 months to 18months, the lower limb functions were well, satisfied with the lower limb flap form and felt soft. Conclusion Free chain-link flap is the good way in the treatment of large areas of the lower leg soft tissue defects.

关 键 词：小腿 外科皮瓣 移植 显微外科手术 

分 类 号：R658.3[医药卫生—外科学]