逆行供血的股前外侧皮瓣游离移植修复肢体创面五例报告  

Reversed arterial flow in free anterior lateral thigh flap surgery for limb reconstruction:report of 5 cases

作　　者：杨勇[1] 田文[1] 李忠哲[1] 李文军[1] 陈山林[1] 田光磊[1] 

机构地区：[1]北京积水潭医院手外科,100035

出　　处：《中国骨与关节杂志》2017年第4期266-269,共4页Chinese Journal of Bone and Joint

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2015-3-036);人力资源和社会保障部留学人员科技活动项目择优资助

摘　　要：目的探讨逆行供血的股前外侧皮瓣游离移植修复肢体创面的适应证、手术要点和临床效果。方法 2012年12月至2016年6月,对5例肢体严重软组织损伤合并主干血管损伤的患者使用逆行供血的游离股前外侧皮瓣移植修复,下肢4例,上肢1例,创面最大面积22 cm×11 cm,最小面积13 cm×8 cm。股前外侧皮瓣的旋股外侧动脉降支分别与皮瓣远端的胫前动脉和桡动脉端端吻合,旋股外侧静脉降支分别与大隐静脉、小隐静脉和头静脉按照生理性回流的方式端端吻合,静脉吻合时均切取小隐静脉移植。结果术后皮瓣血运良好,均完全成活,随访8~14个月,皮瓣外形好,质地柔软。结论对于肢体严重软组织损伤伴主干血管损伤的复杂病例,应用逆行供血的股前外侧皮瓣游离移植进行修复,是一种安全有效的手术方法。Objective To investigate the indications, operative key points and clinical results of the free anterior lateral thigh flap supplied by reversed artery flow for limb reconstruction. Methods From December 2012 to June 2016, 5 cases of massive compound trauma in the forearm and leg were treated with free anterior lateral thigh flap. The artery of flap and its accompanying vein were anastomosed to the distal end of the anterior tibial artery or radial artery and the proximal end of great saphenous vein, small saphenous vein or cephalic vein respectively. Results All flaps presented good blood supply and survived without complications. At 8 to 14 months＇ follow-up, flaps were soft and aesthetically acceptable. Conclusions For compound trauma in the forearm and leg that involves main vessel defect, reconstruction with free anterior lateral thigh flap supplied by the reversed arterial flow is a safe and effective procedure.

关 键 词：外科皮瓣 显微外科手术 创伤和损伤 

分 类 号：R622[医药卫生—整形外科]