游离股前外侧皮瓣在四肢复杂创面修复中的应用  

Application of free anterolateral femoral skin flap in repair of complex wound in extremities

作　　者：王宝云[1] 孙广峰[1] 王达利[1] 魏在荣[1] 唐修俊[1] 金文虎[1] 邓呈亮[1] 胡鹏[1] 昝钦[1] 

机构地区：[1]遵义医学院附属医院整形外科,贵州遵义563003

出　　处：《中国美容整形外科杂志》2013年第9期539-541,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨游离股前外侧皮瓣在四肢复杂缺损创面修复的临床疗效。方法对12例患者的前臂、肘部、小腿、足跟部及足部复杂皮肤软组织缺损，其皮肤缺损面积最小为8cm×6cm，最大为23cm×12cm，其中6例（伴有骨外露）采用吻合血管的游离股前外侧皮瓣移植修复，6例（伴有肌腱缺损）采用携带阔筋膜的游离股前外侧皮瓣I期修复肌腱以及创面，皮瓣切取面积最小为9cm×7cm，最大为25cm×14cm。结果12例患者术后随访6～36个月，其中，10例移植皮瓣完全成活；1例移植皮瓣的边缘有部分坏死，经换药后愈合；1例术后第2天发生动脉危象，经及时手术探查吻合血管后恢复皮瓣血运，皮瓣成活良好；6例伴有肌腱缺损的患者，术后功能恢复满意。结论游离股前外侧皮瓣具有切取方便、供区功能损伤小、血供可靠、切取面积大等优点，是修复四肢皮肤软组织复杂性缺损创面的理想皮瓣之一。Objective To explore the effect of free anterolateral thigh flap in repair of complex wound in extremities. Methods Twelve patients with the complex skin and soft tissue defect in forearm, elbow, leg, heel and foot, ranged from 8 cm×6 cm to 23 cm × 12 cm. Six cases with bone exposure were repaired using free anterolateral femoral skin flap with vascular anastomosis transplantation repair, while the other 6 cases with tendon defect were repaired using free anterolateral thigh flap with the fascia lata at first stage. Results Postoperative follow-up was performed for 6 to 36 months on 12 cases. Skin flaps in 10 cases survived completely, while 1 case was with partly edge necrosis of the flap which was healed after dressing changes ; arterial crisis occurred in 1 case at the second day postoperatively, in which the blood supply of the flap was recovered after timely exploration of vessel anastomosis; function in 6 patients with tendon defect was recovered satisfactorily. Conclusion Free anterolateral thigh flap has the advantages of easy harvest, tiny injury in donor site, reliable blood supply and large harvested area. It is one of the ideal flaps to repair the complex wound in extremities.

关 键 词：股前外侧皮瓣 创面修复 移植 

分 类 号：R622[医药卫生—整形外科]