股前外侧游离皮瓣修复手、腕、足踝等创面32例  

Clinical analysis of repairing hand,wrist,foot and ankle wounds with anterolateral femoral free flap in 32 cases

作　　者：刘仁甫[1] 韩俊[1] 周晓祥 王东平[1] 张孟 邵剑飞 徐为民[1] 孔薛生 LIU Renfu;HAN Jun;ZHOU Xiaoxiang(Department of Hand and Foot Surgery,Dongtai Traditional Chinese Medicine Hospital,Dongtai,Jiangsu,224200,China)

机构地区：[1]东台市中医院手足外科,江苏东台224200

出　　处：《实用手外科杂志》2022年第4期471-473,共3页Journal of Practical Hand Surgery

基　　金：2019年盐城市医学科学技术发展计划项目(项目编号:YK2019087)。

摘　　要：目的探讨股前外侧游离皮瓣修复手、腕、足踝等创面的方法和临床疗效。方法选择2019年6月-2022年6月收治的32例四肢软组织缺损患者(手、腕部13例,足踝部19例),采用股前外侧游离皮瓣移植修复,皮瓣切取面积:17.0 cm×12.0 cm~8.0 cm×6.0 cm,并对手术指征掌握、皮瓣解剖方法、深筋膜的处理、股部供区修复、皮瓣薄化与技术改良等方面进行讨论。结果32例皮瓣全部成活,其中1例大腿接力皮瓣远端边缘少许皮肤坏死,经扩创二期缝合后愈合;2例面积较大的皮瓣远端边缘发绀,经拆线、局部按摩等处理,局部血运恢复。结论股前外侧游离皮瓣为修复手、腕、足踝部创面的理想选择,皮瓣质地柔软,弹性良好,对关节功能有良好的保护作用,适合推广。Objective To explore the method and clinical effect of femoral anterolateral free flap to repair the hand,wrist,ankle and other wounds.Methods From June 2019 to June 2022,32 patients with soft tissue defects of limbs(13 cases of hand tissue defects and 19 cases of foot tissue defects)were treated in the department of hand and foot surgery of our hospital.The defect area:17.0 cm×12.0 cm~8.0 cm×6.0 cm.The anatomical method of skin flap,the treatment of deep fascia,the repair of femoral donor area,and the thinning of skin flap was discussed.Results All 32 flaps survived,of which 1 case had a little skin necrosis at the distal edge of the thigh relay flap,which healed after secondary suture.Two cases was cyanosis at the distal edge of the larger flap,and were treated with suture removal and local massage,and the local blood circulation was restored.Conclusion Femoral anterolateral free flap is an ideal choice for repairing the wound of wrist,foot and ankle.The flap has soft texture and good elasticity,and has a good protective effect on joint function,which is suitable for promotion.

关 键 词：股前外侧皮瓣 皮瓣解剖 筋膜处理 供区修复 显微外科 

分 类 号：R658[医药卫生—外科学]