游离背阔肌扩张皮瓣在膝前大面积组织缺损修复中的应用  

The application of expanded latissimus dorsi free flap in the reconstruction of large-scale anterior knee defects

作　　者：蔡雨宸 张国佑[1] 廉洁 祝联[1] CAI Yuchen;ZHANG Guoyou;LIAN Jie;ZHU Lian(Department of Plastic and Reconstruction Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科》2021年第4期314-316,共3页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨应用游离背阔肌扩张皮瓣修复大面积膝前组织缺损的临床疗效。方法2017年3月至2020年10月,对4例大面积膝前组织缺损应用游离背阔肌扩张皮瓣进行修复。所有患者均行两期手术:一期扩张器植入,扩张器注射5~6个月使组织扩张;二期膝前瘢痕松解,行背阔肌扩张皮瓣转移术修复膝前创面。结果所有患者创面均成功修复。膝前瘢痕切除后,暴露创面缺损面积为16 cm×10 cm~18 cm×12 cm。切取背阔肌皮瓣面积为23 cm×8 cm~25 cm×17 cm。全部患者术后随访6~12个月,膝前区外形美观,软组织质地薄而柔软,膝关节功能恢复良好,供区无继发功能障碍。结论游离背阔肌扩张皮瓣是修复膝前大面积组织缺损的良好选择,术后可获得满意的外形及功能恢复。Objective To investigate the clinical efficacy of expanded latissimus dorsi(LD)free flap in the reconstruction of large-scale anterior knee defects.Methods From March 2017 to October 2020,the technique of expanded LD free flap was applied in 4 patients with large anterior knee defects.A two-staged surgical procedure was performed.In the first stage,tissue expander was implanted at the donor site,followed by expander inflation of 5-6 months for tissue expansion.In the second stage,the anterior knee defect left by scar removal was reconstructed by expanded LD free flap transfer surgery.Results All patients were reconstructed successfully.The defect size after anterior knee scar removal ranged from 16 cm×10 cm to 18 cm×12 cm.The dissected flap ranged from 23 cm×8 cm to 25 cm×17 cm.Follow-up for 6 to 12 months showed good appearance of the anterior knee area with thin and soft tissue coverage,and normal knee mobility.No donor site dysfunction was observed.Conclusion Expanded LD free flap is a good choice for large anterior knee defect reconstruction,bringing satisfactory appearance and function recovery after operation.

关 键 词：游离背阔肌扩张皮瓣 膝前区缺损 组织扩张 

分 类 号：R622[医药卫生—整形外科]