游离腹壁下动脉嵌合穿支皮瓣修复合并深部死腔的下肢皮肤软组织缺损  

Application of free chimeric perforator flap with deep epigastric inferior artery for the soft tissue defect on the lower extremity with deep dead space

作　　者：唐举玉[1] 卿黎明[1] 吴攀峰[1] 周征兵[1] 梁捷予[1] 俞芳[1] 符劲飞 

机构地区：[1]中南大学湘雅医院手显微外科中南大学骨科研究所,长沙410008

出　　处：《中华整形外科杂志》2015年第6期425-428,共4页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金面上资助项目（81472104）

摘　　要：目的 探讨游离腹壁下动脉嵌合穿支皮瓣修复合并深部死腔的下肢创面的可行性及临床效果.方法 2010年3月至2011年8月,采用游离腹壁下动脉嵌合穿支皮瓣修复下肢皮肤软组织缺损8例,分别伴有不同程度的死腔、骨缺损或骨关节外露.其中肌瓣填塞深部死腔,穿支皮瓣覆盖浅表创面.皮瓣供区直接缝合.结果 术后所有皮瓣均顺利存活,皮瓣受区与供区均一期愈合.术后随访12- 24个月,平均16个月,所有皮瓣颜色、质地好,其中2例皮瓣继发肥厚,行皮瓣修薄术.皮瓣供区仅留线性瘢痕,腹壁功能无影响.结论 游离腹壁下动脉嵌合穿支皮瓣只需吻合1组血管蒂,能同时修复深部死腔和体表创面,提高了受区的修复质量,减少供区损害,是修复合并深部死腔创面的较为理想的方法.Objective To explore the feasibility and the effect of free chimeric perforator flap with deep inferior epigastric artery for the soft tissue defect on the lower extremity with deep dead space.Methods From Mar.2010 to Aug.2011, 8 patients with soft tissue defects on the lower extremities combined with dead space, bone or joint exposure were reconstructed with free hinged perforator flaps with deep inferior epigastric artery.The muscle flap was inserted into the deep dead space, with perforator flap for superficial defect.The defects on the donor sites were closed directly.Results All the flaps survived with primary healing.Good color and texture was achieved.The patients were followed up for 12-24 months, with an average of 16 months.2 over-thick flaps were treated by flap-thinning surgery.Only linear scar was left on the donor site on abdomen with no malfunction.Conclusions The free chimeric perforator flap with deep inferior epigastric artery can simultaneously construct the dead space and superficial defect with only anastomosis of one set of vascular pedicle.It is an ideal method with good results on recipient sites and less morbidity on donor sites.

关 键 词：腹壁下动脉穿支皮瓣 外科皮瓣 移植 显微外科 

分 类 号：R658.3[医药卫生—外科学]