股前外侧Flow-through皮瓣修复下肢大面积缺损合并主干动脉缺损  

Repair of large defects of lower limb and main artery defectswith anterolateral thigh flow-through flap

作　　者：周兴 朱自强 谢久虎 郝宝辉 黄立 ZHOU Xing;ZHU Ziqiang;XIE Jiuhu(Department of Hand Surgery,The Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221000,China)

机构地区：[1]徐州医科大学第二附属医院手外科,江苏徐州221000

出　　处：《实用手外科杂志》2024年第2期147-149,160,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨应用股前外侧Flow-through皮瓣修复下肢大面积缺损合并主干动脉缺损的临床疗效。方法2017年9月-2022年3月,应用股前外侧Flow-through皮瓣修复下肢大面积缺损并主干动脉缺损10例,其中合并胫后动脉缺损7例,胫前动脉缺损3例。一期行骨折外固定,VSD覆盖创面,二期行股前外侧Flow-through皮瓣修复术。结果10例皮瓣均成活,1例皮瓣远端少许坏死,经换药后伤口愈合,2例术后出现静脉危象,探查后皮瓣成活。随访8~24个月,平均15个月,皮瓣外观质地良好,5例因皮瓣臃肿行皮瓣修整。供区除伤口瘢痕及色素沉着外,未出现功能影响等并发症。结论股前外侧Flow-through皮瓣穿支可靠,血管蒂长,轴心血管管径粗,可重建主干血管,是修复下肢大面积缺损合并主干动脉缺损的较好选择。Objective To investigate the clinical effect of anterolateral thigh flow-through flap for repairing large defects of lower limb with main artery defect.Methods From September 2017 to March 2022,10 patients with the large defect of lower limb and main artery defect were treated with anterolateral thigh flow-through flap.The combined injures were main defect of posterior tibial artery in 7 patients,and anterior tibial artery in 3 patients.In the first stage,fracture external fixation was performed,VSD covered the wound,and in the second stage,anterolateral femoral flow-through flap repair was performed.Results All 10 cases survived.One flap occured slight necrosis of the distal skin margin,which healed after dressing.Two flaps with venous crisis survived after exploration.The follow-up time was 8-24 months,with an average of 15 months.The flaps showed good appearance and texture.Five patients showed swollen and underwent flap debulking.In addition to wound scar and pigmentation,the donor site had no complications such as functional impact.Conclusion The anterolateral thigh flow-through flap has reliable perforators,long vascular pedicle,thick diameter of axial vessels,and can reconstruct the main vessels.It is a good choice for repairing large area defects of lower limb combined with main artery defect.

关 键 词：股前外侧Flow-through皮瓣 修复 大面积缺损 主干动脉缺损 

分 类 号：R658.3[医药卫生—外科学] R543.5[医药卫生—临床医学]