股前外侧接力穿支皮瓣修复股前内侧穿支皮瓣供区  

Relaying anterolateral thigh(ALT) perforator flap in resurfacing of the donor defect after anteromedial thigh(AMT) perforator flap transfer

作　　者：宋达疆[1] 李赞[1] 周晓[1] 章一新[2] 彭小伟[1] 周波[1] 吕春柳[1] 彭文[1] 王旭[1] 欧延[1] 毛煌兴 Song Dajiang;Li Zan;Zhou Xiao;Zhang Yixin;Peng Xiaowei;Zhou Bo;Lyu Chunliu;Peng Wen;Wang Xu;Ou Yan;Mao Huangxing(Department of Oncology Plastic Surgery,Hunan Cancer Hospital,Changsha 410013,China;Division of Plastic and Reconstructive Surgery,Shanghai Ninth People's Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]湖南省肿瘤医院肿瘤整形外科,长沙410013 [2]上海交通大学医学院附属第九人民医院整形外科,200011

出　　处：《中国医师杂志》2018年第11期1627-1631,共5页Journal of Chinese Physician

基　　金：湖南省自然科学基金面上项目(2018JJ2242);湖南省自然科学基金面上项目(2018JJ2241);湖南省卫计委课题项目(B2014-111);湖南省肿瘤整形外科临床医学研究中心平台建设专项资助(2013TP4087)~~

摘　　要：目的介绍股前外侧接力皮瓣用于修复股前内侧穿支皮瓣供区的经验。方法应用股前内侧穿支皮瓣对16例口腔癌患者颈联合根治术后同期行口腔缺损修复,面积为7. 5 cm×4. 5cm～13. 0 cm×7. 5cm,患者年龄31～72(43. 5±2. 7)岁,所有患者均体重正常(BMI 17. 5～24. 3 kg/m2),股前内侧皮瓣的宽度4. 5～7. 5(6. 3±0. 6) cm,占腿围约12. 5%(9. 8%～15. 7%),供区直接闭合困难,采用股前外侧接力穿支皮瓣转移修复,面积为7. 5 cm×4. 0 cm～12. 0 cm×7. 0 cm。结果本组所有病例股前内侧和外侧穿支恒定存在。所有游离股前内侧穿支皮瓣和接力股前外侧穿支皮瓣均顺利存活。随访8～24个月。所有皮瓣愈合良好,质地色泽满意,外形轮廓美观。股前内侧穿支皮瓣两点辨别觉距离7～14 mm,接力股前外侧穿支皮瓣两点辨别觉距离8～13 mm,肿瘤未复发,大腿功能未见明显影响。结论股前外侧接力穿支皮瓣是修复股前内侧穿支皮瓣供区的理想选择。Objective To introduce the clinical experience of relaying anterolateral thigh (ALT)flap in the resurfacing of the donor defect after anteromedial thigh (AMT) flap transfer.Methods From February 2014 to December 2015,16 cases with oral carcinoma underwent radical resection,leaving tongue or mouth floor defects which were reconstructed by AMT perforator flaps.The flap size ranged from 7.5 cm ×4.5 cm to 13.0 cm × 7.5 cm [the patients was 45.6 years (range 31-72 years),body mass index (BMI) range 17.5-24.3 kg/m^2].Flaps'width was on average 6.6 cm (ranging from 5 to 9 cm) with flap width-to-thigh circumference ratio being 12.5% on average (ranging from 9.8% to 15.7%).The flap donor sites were reconstructed with relaying ALT flap at the same stage,the flap size ranged from 7.5 cm × 4.0 cm to 12.0 cm × 7.0 cm.Results The AMT and ALT perforators existed consistently in all cases of this serie.All free AMT flaps and relaying ALT flaps survived uneventfully.All patients were followed up for 8-24 months with satisfied esthetic and functional results in recipient and donor sites.2-point discrimination distance of AMT flaps ranged from 7 to 14 mm,2-point discrimination distance of relaying ALT flaps ranged from 8 to 15 mm,the function of thighs were not affected.Conclusions The relaying ALT flap is an ideal choice to reconstruct the donor site of free AMT flap.

关 键 词：外科皮瓣 股/外科学 颊/外科学 皮肤移植 

分 类 号：R658.3[医药卫生—外科学]