股前外侧皮瓣移植修复老年四肢软组织缺损  

Anterolateral thigh flap for reconstruction of soft tissue defects of elderly in arms and legs

作　　者：周洪翔[1] 尹宗生[1] 祝斌[2] 宁涛[2] 周洁浩[2] 李俊杰[2] 曹金林[2] 付永彬[2] 陈坚[2] 

机构地区：[1]安徽医科大学第一附属医院骨科,安徽省合肥市230022 [2]安徽省阜阳市人民医院骨科手足显微病区

出　　处：《中国骨与关节损伤杂志》2013年第2期113-115,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨应用股前外侧皮瓣移植修复老年四肢软组织缺损、深部组织外露或合并感染创面的临床疗效。方法应用股前外侧皮瓣移植修复老年创伤性四肢软组织缺损、深部组织外露或合并感染创面23例,其中合并感染创面6例。急诊修复2例,一期清创或扩创、二期皮瓣移植21例。结果皮瓣全部成活22例,无血管危象发生,1例皮瓣尖端坏死经换药植皮后愈合。术后随访2～48个月,平均23个月。皮瓣色泽、质地、外形良好。6例感染创面皮瓣修复后有1例皮瓣下方出现部分感染,经二次扩创、置管闭式冲洗后愈合。皮瓣供区直接闭合3例,供区植皮修复20例,伤口均愈合良好,无明显功能障碍。结论股前外侧皮瓣血管蒂长、恒定、切取面积大,皮瓣血运丰富、抗感染能力强,可携带股外侧肌肉形成肌瓣填塞死腔,供区隐蔽,是修复老年四肢创伤性大面积软组织缺损、深部组织外露的理想皮瓣。Objective To investigate the anterolateral thigh flap for reconstruction of arms and legs soft tissue defects,exposed deep tissue,and the wound infection of elderly patients. Methods Anterolateral thigh flap graft was used to repair 23 cases of traumatic soft tissue defects, exposed deep tissue, and the wound infection of elderly patients in elderly patients, including six cases of wound infection. Two cases underwent emergency surgery repair. Twenty one cases received two stage surgery,first step debridement or secondary debridement,the second step flap transplantation. Results All flaps survived in 22 cases, 1 case flap tip necrosis, none vascular crisis, 1 case the flap tip necrosis after dressing skin graft healing. The postoperative follow-up ranged from 2 to 48 months, with an average of 23 months. Flap color, texture, shape were good. Six cases of infected wounds use flap were repaired, 1 case had partial infection under the flap, through secondary debridement and closed flush catheter wound healed. The flap donor site was closed directly in three cases ,the donor site skin graft was repaired in 20 cases,the wound healed well,there was no significant dysfunction. Conclusion Anterolateral thigh flap artery pedicle has constant location and enough length,large area,rich blood supply,better able resistance to infection,and can carry vastus lateralis muscle as muscle flap to obliterate the dead space. The donor area is covert. It is an ideal flap for repair of large area of soft tissue traumatic defects and exposed deep tissue of limbs.

关 键 词：股前外侧皮瓣 显微外科 软组织缺损 移植 

分 类 号：R628[医药卫生—整形外科]