吻合隐血管的游离皮瓣修复胫前中上段大面积皮肤软组织缺损  

Reconstruction of large skin and soft tissue defect in the front upper of tibia with free flap of anastomosis saphenous vessels

作　　者：周洪杰[1] 隋海明[2] 杜全红[2] 史永安[2] 迟涛胜 丛海波[3] 

机构地区：[1]山东中医药大学,济南250355 [2]山东省文登整骨医院 [3]山东省威海市文登中心医院

出　　处：《中华显微外科杂志》2015年第2期123-126,共4页Chinese Journal of Microsurgery

摘　　要：目的 探讨游离皮瓣修复胫前中上段大面积皮肤软组织缺损时吻合受区隐血管的可行性.方法 2009年6月-2014年4月,收治伴有胫前中上段大面积皮肤软组织缺损患者16例,其中男10例,女6例;年龄24～ 56岁,平均34.5岁,经全身支持治疗并多次清创结合VSD治疗后行创面修复手术,术前均设计采用吻合隐血管的游离股前外侧皮瓣移植修复. 结果 14例按术前设计进行,2例改用吻合健侧胫后血管的交腿皮瓣修复（1例隐动脉管径过细,1例隐动脉长段损伤变性栓塞,均不适合行血管吻合）,14例吻合隐血管的皮瓣全部成活,其中12例一期愈合,2例皮瓣远端尖部部分坏死,经换药后逐渐愈合.13例经过6个月～2年随访,皮瓣外观无臃肿、质地优良,软组织缺损创面修复满意. 结论 胫前中上段大面积皮肤软组织缺损的游离皮瓣移植修复可选择吻合受区隐血管。Objective To explore the feasibility of repairing the large area skin and soft tissue defect in thefront upper of tibia by free flap with anastomosis of saphenous vessels.Methods From June,2009 to April,2014,16 cases （10 males and 6 females） of large area skin and soft tissue defect in the front upper of tibia were treatedwith free flap.The ages ranged from 24 to 56 years old,averaged of 34.5 years old.The supportive therapy and repeated debridement combined with VSD,and designed to use free anterolateral thigh flap with anastomosis of saphenous vessels before repairing operation.Results Fourteen patients accorded with preoperative design,in which 2 cases were adopted cross leg flap anastomosis posterior tibia vessels of the healthy side （1 case of saphenous artery diameter too small,and 1 case of saphenous artery long injury degeneration,unsuitable for vascular anastomosis）.All 14 flaps survived,expect 2 cases were part-necrosis in the end of the flap,and gradually healed by dressing exchange.Conclusion Reconstruction of large area skin and soft tissue defect in the front upper of tibia with free flap can use anastomosis of saphenous vessels.

关 键 词：股前外侧皮瓣 隐血管 胫骨 显微外科技术 

分 类 号：R622[医药卫生—整形外科]