逆行股前外侧皮瓣移位修复胫骨外露创面  

REVERSE ANTEROLATERAL THIGH FLAP FOR REPAIR OF WOUND DEFECTS WITH EXPOSED TIBIA

作　　者：农明善 陈凯宁 杨幸 黄武 

机构地区：[1]武警广西总队医院外二科(创伤中心),南宁530003

出　　处：《中国修复重建外科杂志》2012年第3期316-318,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨逆行股前外侧皮瓣、肌皮瓣修复小腿中上段胫骨外露创面的方法及疗效。方法 2005年10月-2010年4月,应用逆行股前外侧皮瓣、肌皮瓣移位修复小腿中上段胫骨外露创面16例。男10例,女6例;年龄16～52岁。交通事故伤11例,重物压伤5例。10例为伤后1～6 h入院,平均3 h;6例伤后于外院行胫骨骨折钢板内固定术后创面严重感染,伤后至该次入院时间为6～14 d,平均10 d。创面范围13 cm×7 cm～20 cm×13 cm。皮瓣切取范围16 cm×10 cm～23 cm×15 cm。供区取中厚皮游离移植修复。结果术后5～7 d 2例皮瓣发生感染,经换药1周后愈合;其余皮瓣成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合,植皮成活。患者均获随访,随访时间10～23个月,平均18个月。患肢皮瓣外形稍臃肿,色泽、质地满意。骨折均于术后8～10个月愈合。结论采用逆行股前外侧皮瓣、肌皮瓣可有效修复小腿中上段胫骨外露创面。Objective To investigate the method and effectiveness of reverse anterolateral thigh flap and muscle flap for repair of wound defects with exposed tibia in the proximal-middle leg.Methods Between October 2005 and April 2010,16 patients with wound defects with exposed tibia in the proximal-middle leg were treated with reverse anterolateral thigh flap and muscle flap.There were 10 males and 6 females,aged from 16 to 52 years.Injury was caused by traffic accident in 11 cases and by crushing in 5 cases.The disease duration of 1-6 hours（mean,3 hours） in 10 patients and 6-14 days（mean,10 days） in 6 patients,who underwent tibial fracture plate fixation in other hospitals.The size of wound ranged from 13 cm × 7 cm to 20 cm × 13 cm.The size of the flap ranged from 16 cm × 10 cm to 23 cm × 15 cm.The donor sites were covered with splite thickness skin grafts.Results Infection occurred in 2 flaps at 5-7 days and was cured after 1 week of dressing change;the other flaps survived and the wounds healed by first intention.The incisions healed well and the skin grafts survived at the donor sites.All cases were followed up 10-23 months（mean,18 months）.The appearance of the flap was slightly overstaffed,but the color and texture were satisfactory.All fractures healed at 8-10 months after operation.Conclusion It is effective to repair wound defects with exposed tibia in the proximal-middle leg with reverse anterolateral thigh flap and muscle flap.

关 键 词：逆行股前外侧皮瓣 胫骨外露 创面修复 

分 类 号：R658.3[医药卫生—外科学]