游离颞浅筋膜瓣/股前外侧筋膜瓣联合皮片移植修复四肢特殊部位深度组织缺损的临床经验  

Clinical experience of free superficial temporal fascia flap/anterolateral femoral fascial flap combined with skin grafting in repairing deep tissue defects of special parts of extremities

作　　者：杨薛康 张栋梁 何亭 张月 徐志刚 魏婧韬 李军 刘梦栋 Yang Xuekang;Zhang Dongliang;He Ting;Zhang Yue;Xu Zhigang;Wei Jingtao;Li Jun;Liu Mengdong(Department of Burns and Cutaneous Surgery,Burn Center of PLA,the First Affiliated Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院全军烧伤中心,烧伤与皮肤外科,西安710032

出　　处：《中华烧伤与创面修复杂志》2023年第6期507-511,共5页Chinese Journal of Burns And Wounds

基　　金：国家自然科学基金青年科学基金项目(81701902);陕西省重点研发计划一般项目(2023-YBSF-427)。

摘　　要：四肢的深度组织缺损易造成肌腱、血管、神经及骨质外露,临床常采用游离皮瓣修复。但对于手指、足趾、踝后、胫前、足背等特殊部位,采用游离皮瓣修复后外观通常会显得臃肿,后期需行多次去脂手术,给患者造成沉重的生理、心理及经济负担。筋膜瓣柔软、纤薄,且具有血运好、抗感染能力强等优点,利用游离筋膜瓣移植联合皮片移植在此类创面的修复中具有一定优势,但由于手术难度大,术后血运不易观察等不足严重限制了其临床应用。近年来笔者团队在游离颞浅筋膜瓣/股前外侧筋膜瓣联合皮片移植修复四肢特殊部位深度组织缺损方面开展了大量工作,积累了丰富的经验。该文主要从临床角度介绍游离颞浅筋膜瓣/股前外侧筋膜瓣的解剖和切取方法及临床应用的优点、难点和注意事项,供同行参考。The deep tissue defects of extremities are prone to cause the exposure of tendons,blood vessels,nerves,and bones,which are commonly repaired with free flaps in clinical practice.However,for special parts such as fingers,toes,posterior ankles,anterior tibias,and dorsum of feet,the appearances are usually bulky after being repaired with free flaps and need lipectomy operations,which bring great physiological,psychological,and economic burden to patients.As the fascia flap is soft and thin with reliable blood supply and strong anti-infection ability,the free fascia flap combined with skin grafting offers some advantages in repairing the above-mentioned wounds.However,its clinical application is severely limited due to the complexity of surgical operation and the difficulty in observing blood supply after operation.In recent years,our team has carried out a lot of work and accumulated rich experience in repairing deep tissue defects of special parts of extremities with free superficial temporal fascia flap/anterolateral femoral fascial flap combined with skin grafting.From the clinical perspective,this paper mainly introduces the anatomy and harvesting method of free superficial temporal fascia flap/anterolateral femoral fascial flap,as well as the advantages,difficulties,and precautions of clinical application,for reference of peers.

关 键 词：创伤和损伤 外科手术 筋膜瓣 皮片移植 创面修复 

分 类 号：R658[医药卫生—外科学]