逆行股前外侧皮瓣修复膝关节外侧缺损  

Repair of lateral knee joint defect with reverse anterolateral thigh flap

作　　者：彭攀 陈丹洋 柴朗捷 周凌 王敏[1] 郭佳[1] 周伟[1] 郭亮 PENC Pan;CHEN Danyang;CHAI Langie;ZHOU Ling;WANG Min;GUO Jia;ZHOU Wei;GUO Liang(Department of Plastic and Cosmetic Surgery,Zhongnan Hospital of wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院整形美容外科,湖北武汉430071

出　　处：《中国美容整形外科杂志》2024年第7期434-437,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨采用逆行股前外侧皮瓣(distally based anterolateral thigh flap, dALT)修复膝关节外侧缺损的效果。方法 回顾性分析自2021年7月至2022年7月,武汉大学中南医院整形美容科采用dALT修复15例膝关节因治疗后致皮肤全层缺损患者,并分析该治疗方法的治疗效果。结果 15例患者皮瓣术后血供均良好。其中1例皮瓣大部分成活,远端皮缘小部分坏死,通过换药延期愈合,出院后随访6个月,患者的创面愈合稳定,外形恢复较满意,运动功能及左下肢活动无明显限制;另1例治疗后皮瓣大体成活,皮缘周围小部分坏死,同样通过换药延期愈合,随访3个月,患者的皮瓣区域愈合良好,皮肤保护功能完善;其余13例患者治疗后1周内仅出现1例术后血肿的并发症,引流血肿后自愈。结论 dALT移植是一种有效的手术方法,可用于重建膝关节外侧缺损,且并发症发生率较低。Objective To analyze the effect of using a distally based anterolateral thick flap(dALT)to repair lateral knee joint defects.Methods From July 2021 to July 2022,Department of Plastic and Cosmetic Surgery,Zhongnan Hospital of Wuhan University using a retrospective observational study method.We documented and observed the treatment process of 15 patients who underwent full-thickness skin defect repair of the knee joint with a distally based anterolateral thigh flap after previous treatments.We analyzed the effectiveness of this treatment approach.Results All 15 cases showed good blood supply to the flaps post-surgery.In one case,most of the flap survived,but a small portion of the distal edge became necrotic.This was managed with dressing changes,leading to delayed healing.Six months post-discharge,the patient's wound had healed stably,with a satisfactory appearance,and there were no significant restrictions in movement or function of the left lower limb.In another case,the flap largely survived post-treatment,but a small portion around the edge be-came necrotic.Similarly,this was managed with dressing changes,leading to delayed healing.Three months post-surgery,the flap area had healed well,and the skin's protective function was intact.In the remaining 13 patients,only one complication of postoperative hematoma oc-curred within one week after treatment.Healing of hematoma after drainage.Conclusion The transplantation of the distally based antero-lateral thigh flap is an effective surgical method for reconstructing lateral defects of the knee,reducing complications.

关 键 词：膝关节缺损 瘢痕复发 股前外侧皮瓣 逆行皮瓣 

分 类 号：R687.4[医药卫生—骨科学]