游离股前外侧皮瓣在复杂头皮软组织缺损中的应用  

Anterolateral thigh flap in complex scalp defects

作　　者：张有来[1] 李舒琳 陆九州[1] 蒋军健[1] 徐雷[1] 

机构地区：[1]复旦大学附属华山医院手外科,上海200040

出　　处：《骨科》2015年第5期240-243,共4页ORTHOPAEDICS

基　　金：国家卫计委公益性行业科研专项项目(No.201402016)

摘　　要：目的探讨游离股前外侧皮瓣修复复杂头皮软组织缺损的临床疗效。方法应用游离股前外侧皮瓣修复20例复杂头皮软组织缺损患者,其中颅骨外露6例,合并颅骨缺损3例,合并感染4例,合并头皮瘢痕挛缩9例。头皮缺损面积6 cm×10 cm^22 cm×13 cm,颅骨外露6 cm×8 cm^21 cm×12 cm。术后随访观察疗效。结果术后随访6个月至2年,19例皮瓣完全成活,皮瓣柔软,无明显色素沉着。1例小儿患者术后第3天出现皮瓣远端颅顶部部分发黑,予以换药、温盐水热敷、蒂部缝线拆除后皮瓣成活,但遗留色素沉着。20例患者中,仅1例发生供区植皮边缘坏死,予以换药处理后创面愈合。结论游离股前外侧皮瓣可有效修复创伤及肿瘤所致的复杂头皮软组织缺损。Objective To discuss the clinical efficacy of the flee anterolateral thigh flap in complex scalp soft tissue defects. Methods Twenty patients with complex scalp defects were treated with the free anterolateral thigh flap. Six cases had skull exposure, 3 were complicated with skull defect, 4 with soft tissue infection, and 9 with scar contraeture. The extent of defect ranged from 6 cm×10 cm to 22 cm× 13 cm. The size of skull exposure was between 6 cm× 8 cm to 21 cm× 12 cm. The clinical efficacy after operation was observed. Results During a follow-up period of 6 months to 2 years, of 20 patients under going the free anterolateral thigh flap scalp repair, 19 cases achieved satisfactory outcome. The flaps were soft without significant dyspigmentation. One case had apical scaring and hyperpigmentation, possi bly caused by prolonged ischemia on the edge of the flap. The flap survived after conservative treatment. Conclusion Complex scalp defects can be effectively treated with the free anterolateral thigh flap.

关 键 词：头皮缺损 软组织损伤 外科皮瓣 皮肤移植 

分 类 号：R622.1[医药卫生—整形外科]