股前外侧穿支皮瓣修复软组织恶性肿瘤切除术后创面缺损  

Application of anterolateral thigh perforator flap(free or pedicled)to treat wound defects after resection soft tissue malignant tumors

作　　者：任洪军 李斌[2] 赵占卫 REN Hongjun;LI Bin;ZHAO Zhanwei(Department of Hand Surgery,Water Conservancy Hospital of Beijing City,Beijing,100036,China)

机构地区：[1]北京水利医院手外科,北京100036 [2]北京积水潭医院手外科,北京100035

出　　处：《实用手外科杂志》2022年第1期80-83,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨股前外侧穿支皮瓣(游离或带蒂)修复软组织恶性肿瘤切除术后创面缺损的临床效果。方法选取2017年1月-2020年12月收治的20例软组织恶性肿瘤切除患者为研究对象,根据皮瓣手术方式分为股前外侧穿支游离皮瓣组(14例)和股前外侧穿支带蒂皮瓣组(6例),比较两组围术期情况(手术时长、皮瓣愈合时间)以及术后临床疗效,记录并比较两组术后并发症发生情况及术后供区功能恢复情况。结果带蒂皮瓣组手术时间少于游离皮瓣组(P<0.05),两组皮瓣愈合时间差异无统计学意义(P>0.05);术后随访6个月,两组一次性皮瓣成活率均达到100.00%,差异无统计学意义(P>0.05);带蒂皮瓣组术后发生1例静脉回流障碍,两组并发症发生率差异无统计学意义(P>0.05)。两组股前外侧区均完成I期愈合,下肢均未出现任何功能障碍。结论游离和带蒂股前外侧穿支皮瓣修复骨与软组织恶性肿瘤切除术后创面缺损的临床疗效相当,但前者在重建灵活性方面有一定优势,且两组术后并发症发生率差异无统计学意义。Objective To investigate the clinical effect of anterolateral thigh perforator flap(free or pedicled)in treatment of soft tissue defects after resection of malignant soft tissue tumors.Methods 20 cases with soft tissue malignant tumors in our hospital from January 2017 to December 2020 were selected as the research objects.According to the flap operation method,they were divided into ALT perforator free flap group(14 cases)and thigh pedicled flap group(6 cases),the perioperative conditions(operating time and flap healing time)and postoperative clinical efficacy of the two groups of patients were compared.And the postoperative complications and the postoperative donor site and functional recovery were recorded and compared between the two groups.Results The operation time in pedicled flap group was less than in the free flap group(P<0.05),there was no significant difference in the healing time of the skin flaps between the two groups(P>0.05).After 6 months of follow-up,the survival rate of the primary flap in both groups reached 100.00%,and the difference was not statistically significant(P>0.05).One case of venous congestion occurred in the pedicled skin flap group,and there was no significant difference in the incidence of complications between the two groups(P>0.05).The donor site of the two groups both well healed with no obvious complication.After 6 months of follow-up,there was no functional impairment in the lower extremity in the two groups of patients.Conclusion Both free or pedicle ALT perforator flap technique has the same clinical efficacy in the treatment of wound defects after soft tissue malignant tumor resection,but the free flap has some advantages of versatility with the same low postoperative complication rate.

关 键 词：股前外侧穿支皮瓣 游离皮瓣 软组织恶性肿瘤 

分 类 号：R738.6[医药卫生—肿瘤]