原位保留股外侧皮神经修薄游离股前外侧穿支皮瓣修复下肢软组织缺损  

Application of free thin anterolateral thigh perforator flap retaining lateral femoral cutaneous nerve in situ in the repair of lower limb soft tissue defects

作　　者：任群峰[1] 邹永根 宋达疆[3] 周鑫 REN Qun-feng;ZOU Yong-gen;SONG Da-jiang;ZHOU Xin(Department of Critical Care Medicine,Chenzhou First People’s Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院重症医学科,湖南郴州423000 [2]西南医科大学附属中医医院烧伤整形科,四川泸州646000 [3]湖南省肿瘤医院肿瘤整形外科,湖南长沙410008

出　　处：《中国美容整形外科杂志》2021年第6期362-364,368,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：湖南省肿瘤整形外科临床医学研究中心平台建设专项(2013TP4087);湖南省科卫联合项目(2018JJ6028);湖南省卫健委课题(B2019092);长沙市科技计划基础研究项目(kq1901074、kq1901077)。

摘　　要：目的探讨制备保留股外侧皮神经修薄游离股前外侧穿支皮瓣移植修复下肢软组织缺损的可行性及临床疗效。方法自2015年5月至2019年12月,郴州市第一人民医院采用保留股外侧皮神经修薄游离股前外侧穿支皮瓣修复11例下肢外伤患者的皮肤软组织缺损创面,缺损面积为13.0 cm×4.5 cm~28.0 cm×7.5 cm。制备修薄股前外侧穿支皮瓣的同时保留股外侧皮神经分支于原位,所有皮瓣供区创面直接闭合,皮瓣切取面积为13.0 cm×5.0 cm~28.5 cm×8.0 cm,修薄皮瓣厚度为0.7~1.8 cm,平均1.2 cm。结果术后所有皮瓣均顺利成活。随访12~42个月,平均18.6个月。供受区功能无影响,皮瓣质地和色泽与周围皮肤接近,外形不臃肿,避免了行二期修薄;两点辨别觉距离为7.5~14.5 mm,平均11.5 mm。大腿皮瓣供区仅遗留线性瘢痕。结论一期保留股外侧皮神经修薄游离股前外侧穿支皮瓣移植可以保留供区感觉神经功能完整性,适合修复下肢浅表缺损。Objective To explore the feasibility and clinical efficacy of free thin anterolateral thigh perforator flap retaining lateral femoral cutaneous nerve in situ in the repair of lower limb soft tissue defects. Methods From May 2015 to December 2019, 11 patients with lower limb trauma underwent free thin anterolateral thigh perforator flap retaining lateral femoral cutaneous nerve in situ were retrospectively analyzed. The area of skin and soft tissue defects ranged from 13.0 cm×4.5 cm to 28.0 cm×7.5 cm. The branches of lateral femoral cutaneous nerve were preserved in situ while anterolateral thigh perforator flap was harvested. The defects in donor sites in all patients were directly closed. The size of harvested flap ranged from 13.0 cm×5.0 cm to 28.5 cm×8.0 cm. The thickness of thin flap ranged from 0.7 cm to 1.8 cm, with an average of 1.2 cm. Results All flaps survived well after operation. The follow-up ranged from 12 to 42 months,with an average of 18.6 months. The function of donor site and recipient site were not affected. The texture and color of flaps were closed to surrounding skin. The appearance of flap was not bloated. No secondary thinning was required. The distance of static 2-point discrimination was from 7.5 mm to 14.5 mm, with an average of 11.5 mm. There was no significant effect on the sensation and function of donor site of flap,only linear scar was left. Conclusions The free thin anterolateral thigh perforator flap retaining lateral femoral cutaneous nerve in situ can preserve the integrity of sensation and nerve function of the donor site. This method is suitable for the repair of superficial defects of the lower limb.

关 键 词：股前外侧穿支皮瓣 股外侧皮神经 皮肤软组织缺损 二期修薄 下肢 

分 类 号：R658.3[医药卫生—外科学]