股前外侧皮瓣移植修复四肢软组织缺损580例临床分析  

Clinical analysis of 580 cases treated with anterolateral thigh flap transplantation in repairing soft tissue defect of limb

作　　者：吴晓荣[1] 施明宏 郑能方 程建和[1] 郭金星[1] 瞿年兵 甘坤平 WU Xiaorong;SHI Minghong;ZHENG Nengfang(The 184 Hospital of the Chinese People's Liberation Army,Yingtan,Jiangxi,335000,China)

机构地区：[1]中国人民解放军第184医院骨科,江西鹰潭335000

出　　处：《实用手外科杂志》2018年第4期429-431,436,共4页Journal of Practical Hand Surgery

摘　　要：目的总结股前外侧皮瓣移植术的临床应用经验。方法分析2007年1月-2016年10月开展的580例583块股前外侧皮瓣移植手术的病例资料,对皮瓣切取的手术操作步骤,血管蒂及其血管变异类型,主干血管桥接游离股前外侧皮瓣的应用,双叶穿支皮瓣及串联皮瓣的应用,修薄股前外侧皮瓣的应用,失败病例等方面进行总结。结果本组共移植皮瓣580例583块,完全成活566例。术后发生血管危象12例,经探查及相应处理后完全成活7例,部分坏死2例,完全坏死3例;因穿支细小皮瓣部分坏死4例;术中因无供血皮支或手术误伤皮支放弃移植5例。皮瓣成活率97.6%。随访3～24个月,皮瓣外形满意,皮瓣质地柔软,厚度适中,有弹性,有排汗功能,皮瓣恢复部分浅感觉。结论股前外侧皮瓣移植成功率高、血管变异少,修复四肢软组织缺损临床效果满意。Objective To summarize the experience of clinical application of anterolateral thigh flap transplantation.Methods To analyze 580 cases of 583 anterolateral thigh flaps transplantation from January 2007 to October 2016.The procedure of flap dissection,type of vascular pedicle and its vascular variation were summarized.The application of main blood vessel bridge graft with free anterolateral thigh flap,the bilobed perforator flap and series free flap,and the thinned anterolateral thigh flap,and the failure cases were also summed up.Results There were 583 flaps transplantation cases,including 3 series free flap,43 bilobed perforator flap,21 main blood vessel bridge graft with free anterolateral thigh flap in repairing severe limb trauma in emergency,113 thinned anterolateral thigh flaps.5 cases were cancelied in the operation due to cutaneous branch devascularized or surgical injury.And 12 vascular crisis at post-operation underwent exploration and corresponding treatment,7 completely alive,2 partially necrosis and 3 completely necrosis.4 had partial necrosis because the perforator was tiny.And the total success rate was 97.6%.Patients were followed up 3 to 24 months.The flaps were soft,moderate thickness and elasticity,with satisfactory shape.And the flaps restored perspiration with superficial sensory partial recovery.Meanwhile,218 flaps appeared swollen after surgery which further reconstruction was needed.Conclusion The anterolateral thigh flap transplantation can obtain .satisfactory effect on the clinical treatment of soft tissue defect of limbs with a high success rate and less vascular variation.

关 键 词：四肢 股前外侧皮瓣 移植 显微外科手术 

分 类 号：R658[医药卫生—外科学]