健侧小腿内侧皮瓣桥接游离胸脐皮瓣修复下肢大面积软组织缺损  

The medial-lower-leg-flap with a healthy limb cross-leg bridging thoracic umbilical flap to repair large-area skin defects of lower limbs

作　　者：翟瑞华[1] 刘春娟[1] 王燕燕 王建国 张孝红[1] Zhai Ruihua;Liu Chunjuan;Wang Yanyan;Wang Jianguo;Zhang Xiaohong(Trauma Department of Orthopedics,Yidu Central Hospital of Weifang,Weifang 262500,China)

机构地区：[1]潍坊市益都中心医院创伤骨科,262500 [2]青州市中医院骨科,262500

出　　处：《中华整形外科杂志》2018年第7期538-541,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨以健侧小腿内侧皮瓣交腿桥接游离胸脐皮瓣移植，修复下肢大面积缺损的临床效果。方法设计健侧小腿内侧皮瓣桥接游离胸脐皮瓣，修复一侧小腿严重外伤导致的大面积软组织缺损患者16例，皮瓣血管蒂和对侧胫后动、静脉吻合，蒂部制成皮管，术后4周断蒂。观察术后皮瓣成活状况、色泽、外形、弹性及有无瘢痕挛缩、功能障碍等。结果16例皮瓣均成活，1例术后10h因疼痛出现动脉危象，经镇痛及镇静后缓解，其余15例均无血管危象出现。随访2个月至2年，皮瓣色泽、弹性、外形均满意，感觉恢复可。双膝、踝关节无明显影响。结论对伤肢无可供血管蒂、以往曾行局部皮瓣转移或交腿皮瓣不能修复的下肢大面积软组织缺损，以健侧小腿内侧皮瓣交腿桥接游离胸脐皮瓣修复，可收到较好效果，对挽救濒临截肢的患肢具有重要意义。Objective To investigate the clinical application of repairing the large-area skin defect of legs with medial-lower-leg-flap with a healthy limb cross-leg bridging thoracic umbilical flap. Methods 16 cases with a large area of soft tissue defects caused by severe trauma were included in this study. The vascular pedicles of free thoracic umbilical flap were anastomosed with the opposite posterior tibial artery and vein, and the pediele skin tubes were made and amputated 4 weeks after surgery. Observation of postoperative flap include survival situation, shape, color, elastic, scar contracture, and dysfunction. Results 16 cases of postoperative all flaps survived. In 1 case pain occurred 10 hours after the operation and led to arterial crisis, which was relieved with analgesia. There were no vascular crisis in other 15 eases. Followed up for 2 -24 months, all the flaps survived with good color, elasticity and sensory recovery. There was no apparent stiffness in double knee and ankle joint. Conclusions For the injured limbs impossible to be repaired with local vascular pedicle, routine local transfer of skin flap or cross leg skin flap,the bridge cross anastomosis of free flap graft may be an ideal surgical treatment.

关 键 词：小腿内侧皮瓣 胸脐皮瓣 桥式吻合 修复 

分 类 号：R658.3[医药卫生—外科学]