游离股前外侧穿支皮瓣修复足踝部软组织缺损  

Repair of soft tissue defect of foot and ankle with free anterolateral femoral perforator flap

作　　者：杨小文 古欣庆 汪金平 曾凡雨 陈永健 YANG Xiaowen;Guxinqing;WANG Jinping(Microsurgery of Hand and Foot,Shenzhen Overseas Chinese Hospital Affiliated to Jinan University,Shenzhen,Guangdong,518000,China)

机构地区：[1]暨南大学附属深圳华侨医院手足显微外科,广东深圳518000 [2]广州和平骨科医院手外科,广东广州510317

出　　处：《实用手外科杂志》2022年第2期195-196,199,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨采用游离股前外侧穿支皮瓣修复足踝部软组织缺损的临床效果。方法 2018年1月-2020年10月,采用游离股前外侧穿支皮瓣修复足踝部创面12例,其中修复足背部创面8例,踝部创面4例。切取股前外侧皮瓣最大面积18.0 cm×8.5 cm,最小7.0 cm×4.0 cm。术后规律随访皮瓣外观、耐磨性、感觉恢复情况及供区损伤情况。结果 本组12例皮瓣均成活,1例皮瓣术后24 h内出现静脉危象,经手术探查重新吻合静脉后皮瓣成活。3例皮瓣因切取面积过大供区无法直接缝合,取游离皮片植皮覆盖供区创面;其余皮瓣供区均直接缝合。术后随访12~18个月,平均15个月,皮瓣外形美观,未见溃疡形成。患足功能根据AOFAS踝-后足评分,优6例,良4例,可2例。结论 应用游离股前外侧穿支皮瓣修复足踝部软组织缺损,皮瓣可切取面积大,质地优良,患肢功能恢复好,值得临床推广。Objective To investigate the clinical effect of free anterolateral femoral perforator flap in repair of soft tissue defect of foot and ankle. Methods From January 2018 to October 2020, 12 cases of foot and ankle wounds were repaired with free anterolateral femoral perforator flap, including 8 cases of dorsal foot wounds and 4 cases of ankle wounds. The maximum area of the anterolateral thigh flap was 18.0 cm ×8.5cm, and the minimum area was 7.0 cm×4.0 cm. The appearance, wear resistance, sensory recovery and damage of the donor site were followed up regularly after operation. Results In this group, all 12 flaps survived, and 1 patient developed venous crisis within 24 hours after the operation. In 3 cases, the donor site could not be sutured directly because the cut area was too large, and free skin grafts were used to cover the donor site wounds. The rest of the flap donor site can be directly sutured. Postoperative follow-up was 12~18 months, with an average of 15 months. The skin flap was beautiful in appearance and no ulceration was found during follow-up. According to the AOFAS ankle-hindfoot score, the function of the affected foot was excellent in 6 cases, good in 4 cases, and fair in 2 cases. Conclusion The application of free anterolateral thigh perforator flap to repair the soft tissue defect of the foot and ankle has a large excisable area, good texture, and good function recovery of the affected limb, which is worthy of clinical promotion.

关 键 词：股前外侧穿支皮瓣 足踝部 软组织缺损 显微外科 

分 类 号：R658.3[医药卫生—外科学]