游离股前外侧皮瓣修复四肢Gustilo Ⅲ型开放性骨折合并皮肤软组织缺损  

Treatment experience of free anterolateral thigh flap in the treatment of Gustilo Ⅲ open fractures of extremities with skin and soft tissue defects

作　　者：张树新 邬慧萍 许永先 邹旭 詹森海 邹阳平 霍柱根 ZHANG Shuxin;WU Huiping;XU Yongxian(Department of Hand and Foot Surgery,Nanhai District Public Health Hospital,Foshan,Guangdong,528226,China)

机构地区：[1]佛山市南海区公共卫生医院手足外科,广东佛山528226

出　　处：《实用手外科杂志》2022年第2期176-178,共3页Journal of Practical Hand Surgery

基　　金：佛山市南海区十四五医学重点专科建设项目(项目编号:南卫健[2021]211号)。

摘　　要：目的 探讨应用游离股前外侧皮瓣修复四肢Gustilo Ⅲ型开放性骨折合并皮肤软组织缺损的临床疗效。方法 2017年3月-2019年11月,对8例四肢Gustilo Ⅲ型开放性骨折合并皮肤软组织缺损的患者采用游离股前外侧皮瓣修复,其中修复小腿4例,修复足部创面2例,修复前臂创面2例。结果8例皮瓣全部成活,其中1例发生血管危象,经手术探查后皮瓣成活;1例创面感染,伤口延迟愈合。8例均获得随访,随访时间为6~24个月,平均12个月。皮瓣外观无臃肿,血运良好,质地柔软,两点辨别觉为7.5~11.0 mm,四肢功能恢复良好。结论 应用股前外侧皮瓣修复四肢Gustilo Ⅲ型开放性骨折合并皮肤软组织缺损临床效果良好。Objective To explore the clinical effect of free anterolateral thigh flap in the treatment of open fracture of extremities with skin and soft tissue defect of Type Ⅲ Gustilo. Methods From March 2017 to November 2019, free anterolateral thigh flap was used to repair wounds in eight patients with open fractures of type Ⅲ of Gustilo in the extremities with skin and soft tissue defects. Among those cases, 4 cases were repaired in lower leg wound, 2 cases in foot wound and 2 cases in forearm wound. Results All the flaps survived in 10 cases. Vascular crisis happened in one case, and the flap survived after surgical exploration. One case delayed healing because of wound infection. All 8 cases were followed up for 6-24 months, with an average of 12 months. In 8 cases, the skin flap had no puffy appearance, with good blood circulation and soft texture. The discrimination of two points was 7.5-11.0 mm, and the function of limbs recovered well. Conclusion The application of anterolateral thigh flap in the treatment of open fracture of extremities with skin and soft tissue defect of Gustilo Ⅲ has a good clinical effect.

关 键 词：股前外侧皮瓣 开放性骨折 显微外科手术 

分 类 号：R687.3[医药卫生—骨科学]