双叶股前外侧穿支皮瓣修复足部复杂软组织缺损  

Application of bifoliate anterolateral thigh perforator flap in the repair of multiple soft tissue defects in foot

作　　者：王思夏[1] 战杰[1] 吴锦生[1] 孙鹏[1] 申林[1] WANG Si-xia;ZHAN Jie;WU Jin-sheng;SUN Peng;SHEN Lin(Department of Hand Surgery,The Affiliated Central Hospital of Shenyang Medical College,Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院手外四科,辽宁沈阳110024

出　　处：《中国美容整形外科杂志》2021年第2期111-113,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨双叶股前外侧穿支皮瓣修复足部复杂软组织缺损的临床效果。方法回顾自2014年9月至2019年8月,沈阳医学院附属中心医院手外四科应用双叶股前外侧穿支皮瓣修复足部复杂软组织缺损11例患者的临床资料。切取股前外侧皮瓣面积14 cm×6 cm~18 cm×8 cm,分叶皮瓣面积7 cm×5 cm~11 cm×8 cm。缝接穿支皮瓣与足部相对应的动脉、静脉及感觉神经,11例供区均一期直接缝合,未进行植皮。结果本组共11例22个皮瓣均成活,无坏死与感染发生。3例6个分叶皮瓣外形臃肿,行二次整形手术,外形及功能满意。所有患者术后获随访6~30个月,皮瓣血运佳,质地柔软,外形满意,无皮瓣移植导致的足部功能障碍。将股外侧皮神经保留在皮瓣内,与受区的感觉神经缝接,皮瓣感觉恢复S3+级2个,S3级11个,S2级6个,S1级3个。供区一期直接缝合,无明显瘢痕增生,未见供区发生骨筋膜室综合征。结论股前外侧穿支皮瓣血运丰富,供区隐蔽。采用分叶设计的方式可以有效地修复足部复杂软组织缺损。Objective To explore the clinical efficacy of bifoliate anterolateral thigh perforator flap in the repair of multiple soft tissue defects in foot.Methods From September 2014 to August 2019,the clinical data of 11 patients with soft tissue defects in foot underwent the repair of bifoliate anterolateral thigh perforator flap were reviewed.The area of harvested anterolateral thigh flap was from18 cm×8 cm to 14 cm×6 cm and the lobulated flap was 11 cm×8 cm to 7 cm×5 cm.The artery,vein and sensory nerve of the perforator flap were anastomosed with the recipient area of foot.The donor areas of 11 patients were directly sutured.No skin grafting was given.Results A total of 22 flaps(11 patients)survived without necrosis and infection.The bloated appearance occurred in 6 lobulated flaps(3 patients)and satisfactory appearance and function obtained after secondary operation.All patients were followed up for 6 to 30 months.The blood supply was good,texture was soft and the appearance was satisfactory.No foot dysfunction caused by flap transplantation was found.The lateral femoral cutaneous nerve in the flap was anastomosed with the sensory nerve in the recipient area.The sensory recovered to S3+in 2 flaps,S3 in 11 flaps,S2 in 6 flaps and S1 in 3 flaps.The donor area was directly sutured.No obvious scar and osteofascial compartment syndrome were found.Conclusion The anterolateral thigh perforator flap has abundant blood supply and concealed donor area.This design can effectively repair multiple soft tissue defects in foot.

关 键 词：双叶股前外侧穿支皮瓣 穿支皮瓣 旋股外侧动脉 足 软组织缺损 

分 类 号：R658.3[医药卫生—外科学]