腹壁下动脉穿支皮瓣游离移植修复下肢大面积缺损  

Soft tissue repair of large defects of lower limbs with deep inferior epigastric perforator flap

作　　者：张兆祥[1] 郭树忠[1] 耿健[1] 夏文森[1] 

机构地区：[1]第四军医大学西京医院全军整形外科研究所,西安710032

出　　处：《中华显微外科杂志》2013年第1期15-18,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨腹壁下动脉穿支皮瓣（DIEP）皮瓣游离移植修复下肢外伤后大面积严重缺损的方法及疗效。方法2009年7月一2011年11月，应用腹壁下动脉穿支皮瓣（DIEP）游离移植修复下肢外伤后大面积严重缺损患者共8例，其中足底外伤后全部缺损伴肌腱外露3例，胫骨骨折术后钢板外露伴大面积缺损3例，足跟部外伤植皮术后反复破溃2例。结果术后除1例皮瓣远端血运不良经积极处理后成活外，其余皮瓣全部成活良好，术后3例皮瓣略显臃肿，经皮瓣修薄后外形良好，其余外形及功能良好，患者均较满意。结论DIEP皮瓣存活率高；皮瓣为穿支皮瓣，保留全部腹直肌，避免了腹部并发症的发生。DIEP皮瓣游离移植是修复下肢外伤后大面积严重缺损的理想方法。Objective To study the method and effect of deep inferior epigastric perforator flap（DIEP） in repairing the large defects of lower limbs. Methods Eight cases, from July 2009 to November 2011, in- cluding 3 cases of plantar skin defects with bone exposure after foot injuries, three cases of plate exposure after tibia fracture surgery and 2 cases of heel repeated ulceration after skin graft, were repaired by deep inferior epi- gastric perforator flap. Results All deep inferior epigastric perforator flaps survived with good functions, ex- cept 1 case whose distal with poor blood supply and the flap survived after treatmenting, three cases of flap bloated with good appearances after second operation. Conclusion DIEP is a proper option for repair of large defects of lower limbs. It has the advantages of abundant blood supply, large flap area, abdomen can suturing without abdominal complications.

关 键 词：下肢 腹壁下动脉穿支皮瓣 移植 显微外科手术 

分 类 号：R65[医药卫生—外科学]