多角形胭动脉外侧穿支皮瓣修复儿童腘窝瘢痕挛缩  

Reconstruction of postburn popliteal fossa cicatricial contracture by using modified lateral popliteal artery perforator flap in children

作　　者：聂开瑜[1] 陈伟[1] 魏在荣[1] 金文虎[1] 唐修俊[1] 邓呈亮[1] 吴必华[1] 孙广峰[1] 

机构地区：[1]遵义医学院附属医院烧伤整形外科,贵州遵义563000

出　　处：《中国美容整形外科杂志》2017年第2期83-85,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：国家自然科学基金(81660325;81360295);国家临床重点专科建设项目(国卫办医函[2013]544);贵州省优秀青年科技人才培养对象专项资金项目(黔科合人字(2013)12号)

摘　　要：目的探讨多角形腘动脉外侧穿支皮瓣修复儿童胭窝瘢痕挛缩的可行性及效果。方法对腘窝瘢痕挛缩的患儿行瘢痕松解后,采用多角形腘动脉外侧穿支皮瓣移位修复胭窝创面(5.0 cm×5.0 cm^7.0 cm×9.0 cm),皮瓣切取范围为5.0 cm×6.0 cm^8.0 cm×10.0 cm。供区采用游离植皮修复。结果本组共8例患儿,术后所有皮瓣完全存活。其中,2例供区移植皮片部分坏死,经换药后愈合,其余供、受区切口均一期愈合。随访10~24个月,皮瓣色泽、质地及外形良好,患肢无跛行,膝关节活动范围0°~130°,供、受区均无直线瘢痕形成。结论采用多角形胴动脉外侧穿支皮瓣修复儿童腘窝部瘢痕松解创面,后期无直线瘢痕形成,降低了膝关节再次屈曲挛缩的风险,符合整形外科基本原则。Objective To explore the feasibility and effectiveness of modified lateral popliteal artery perforator flap in repairing popliteal fossa scar contraeture in children. Methods Modified lateral popliteal artery perforator flaps were used to reconstruct wounds after popliteal fossa scar remission. The wound area ranged from 5.0 cm × 5.0 cm to 7.0 cm × 9.0 cm, and the flap size ranged from 5.0 cm x 6.0 cm to 8.0 cm × 10.0 cm. The donor area was repaired with free skin graft. Results Eight children with popliteal fossa ci- catricial contracture were admitted. All pedicled flaps survived; the incisions in donor sites and recipient sites were healed by first intention. The skin graft at donor sites were with partial necrosis in 2 cases, and healed after changing dressings. All children were followed up for 10 to 24 months. The color, texture, and appearance of the flaps were good. No claudication or functional disturbance of the knee joints occurred. The range of motion （ROM） of the knee was 0° to 130°. There was no linear scar formation at donor sites or recipient sites. Conclusion The popliteal perforator flap pedicled with polygonal popliteal artery was used to repair the scar of the popliteal fossa in children. This method can avoid linear scar formation and reduce the risk of knee flexion contraeture. It conforms to the basic principles of plastic surgery.

关 键 词：穿支皮瓣 胭动脉 瘢痕挛缩 

分 类 号：R726.8[医药卫生—儿科]