带肌瓣的旋股外侧动脉降支穿支皮瓣修复合并死腔的小腿软组织缺损  

Repair of soft tissue defect of lower extremity with dead cavity with perforator flap of descending branch of lateral circumflex femoral artery with muscle flap

作　　者：周望高 张振伟 余少校 李东扬 叶学浪 林慧鑫 柯于海 ZHOU Wang-gao;ZHANG Zhen-wei;YU Shao-xiao;LI Dong-yang;YE Xue-lang;LIN Hui-xin;KE Yu-hai(Department of Hand Surgery,Shenzhen Hospital of Integrated Traitional and Western Medicine,Shenzhen 518104,China)

机构地区：[1]深圳市中西医结合医院手外科,广东深圳518104

出　　处：《中国美容整形外科杂志》2021年第7期411-414,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨带肌瓣的旋股外侧动脉降支穿支皮瓣修复合并死腔的小腿软组织缺损的临床疗效。方法自2015年1月至2019年12月,对深圳市中西医结合医院手外科收治的12例合并死腔的小腿软组织缺损伤的患者,采用带肌瓣的旋股外侧动脉降支穿支皮瓣修复,皮瓣切取面积6.0 cm×6.0 cm~15.0 cm×8.0 cm,肌瓣体积5.0 cm×3.0 cm×3.0 cm~13.0 cm×3.0 cm×3.0 cm。皮瓣的穿支动脉与受区的胫前动脉或胫后动脉吻合,伴行静脉与受区胫前动脉或胫后动脉的伴行静脉吻合。术后定期随访。结果12例皮瓣未发生血管危象,全部成活,伤口均无感染,一期愈合。随访6~18个月,皮瓣成活且外形良好,无臃肿、溃疡、骨髓炎发生,患肢功能恢复较满意。结论带肌瓣的旋股外侧动脉降支穿支皮瓣抗感染力强,能良好的填塞死腔,有效地预防伤口感染及骨髓炎的发生,临床效果好,是一种良好修复合并死腔的小腿软组织缺损的治疗方法。Objective To explore the clinical effect of the perforator flap of the descending branch of the lateral circumflex femoral artery with muscle flap in repairing the soft tissue defect of the lower extremity with dead cavity.Methods From January 2015 to December 2019,12 cases of leg soft tissue defect with dead cavity were treated with the perforating branch flap of the descending branch of the circumflex femoral artery with muscle flap.The flap area was 6.0 cm×6.0 cm~15.0 cm×8.0 cm,and the muscle flap volume was 5.0 cm×3.0 cm×3.0 cm~13.0 cm×3.0 cm×3.0 cm.The perforator artery of the flap was anastomosed with the anterior tibial artery or posterior tibial artery of the recipient area,and the accompanying vein was anastomosed with the anterior tibial artery or posterior tibial artery of the recipient area.The patients were followed up regularly.Results All the flaps survived without vascular crisis,with little exudation and no infection.After 6~18 months follow-up,the flap survived well,had good appearance,no bloated,no ulcer,no osteomyelitis,and the functional recovery of the affected limb was satisfactory.Conclusion The perforator flap of the descending branch of the lateral circumflex femoral artery with muscle flap has strong anti infectivity,can eliminate the dead cavity well,effectively prevent the occurrence of wound infection and osteomyelitis,and has good clinical effect.It is a good treatment method for repairing the soft tissue defect of the leg with dead cavity.

关 键 词：穿支皮瓣 旋股外侧动脉 死腔 修复 软组织缺损 

分 类 号：R658.3[医药卫生—外科学]