双侧旋股外侧动脉降支穿支皮瓣组合移植治疗上肢大面积组织缺损皮漪  

Combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs

作　　者：周征兵[1] 唐举玉[1] 吴攀峰[1] 俞芳[1] 潘丁[1] 曾磊[1] 肖勇兵[1] 庞晓阳[1] 卿黎明[1] 刘睿[1] Thou Zhengbing;Tang Juyu;Wu Panfeng;Hu Fang;Pan Ding;Zeng Lei;Xiao yongbing;Pang Xiaoyang;Qng Liming;Liu Rui(Department c^Hand and Microsui^gety, Xiangya Hospital, Central South University, Changsha 410008, China)

机构地区：[1]中南大学湘雅医院手显微外科,长沙410008

出　　处：《中华手外科杂志》2019年第3期183-185,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨双侧旋股外侧动脉降支穿支皮瓣组合移植修复上肢大面积皮肤软组织缺损的可行性与临床效果。方法自2014年1月至2018年6月采用双侧旋股外侧动脉降支穿支皮瓣组合移植,一期修复上肢大面积皮肤软组织缺损患者22例,供区直接闭合。创面涉及上臂、前臂、手部和肘部残端,缺损面积16cm×13cm^40cm×15cm。结果21例组合皮瓣完全存活(95.45%);1例皮瓣远端部分坏死,经二期植皮愈合。皮瓣供区均Ⅰ期直接闭合,无供区并发症发生。随访时间为3~38个月,平均20个月,所有病例创面愈合良好,肢体功能恢复。结论利用双侧旋股外侧动脉降支穿支皮瓣组合移植,操作简便,穿支血管可靠,皮瓣可切取面积大,且供区损伤小,是一期修复上肢大面积皮肤软组织缺损的有效方法。Objective To explore the feasibility and clinical efficacy of combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs. Methods From January 2014 to June 2018, 22 patients with large area skin and soft tissue defects of upper extremities were treated with bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery. The donor site was closed directly. The wound involved upper arm, forearm, hand and elbow stump. The area of defect ranged from 16 cm×13 cm to 40 cm×l5 cm. Results Twenty-one cases (95.45%) of the combined flaps survived completely. One case had partial necrosis of the distal part of the flap, which was healed by second-stage skin grafting. The donor sites of the flaps were closed directly and achieved primary healing without complications. The follow-up period ranged from 3 to 38 months with an average of 20 months. All the cases had good wound healing and limb functional recovery. Conclusion The combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery is an effective method for repairing large skin and soft tissue defects of upper extremities. The operation is simple, the perforator vessel is reliable and the flaps can be cut in large area with less damage to donor site.

关 键 词：上肢 外科皮瓣 旋股外侧动脉降支 上肢重建 

分 类 号：R658.2[医药卫生—外科学]