股前外侧穿支皮瓣游离移植修复四肢皮肤缺损的临床疗效  

Clinical Efficacy of Anterolateral Thigh Perforator Flap Free Transplantation onRepairing Skin Defects of Limbs

作　　者：李康[1] 岳文强 张宏峰[2] LI Kang;YUE Wenqiang;ZHANG Hongfeng(Department of Burn Plastic Hand and Foot Surgery,Yan'an People's Hospital,Yan'an 716000,Shaanxi,China;Department of Burn Plastic Hand Surgery,Affiliated Hospital of Yan'an University,Yan'an 716000,Shaanxi,China)

机构地区：[1]延安市人民医院烧伤整形手足外科,陕西延安716000 [2]延安大学附属医院烧伤整形手外科,陕西延安716000

出　　处：《中国美容医学》2024年第12期35-38,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究股前外侧穿支皮瓣游离移植修复四肢皮肤缺损的临床疗效。方法:选取2018年6月-2023年9月笔者医院收治的98例四肢皮肤缺损患者进行研究,患者皮肤软组织缺损面积为6.12 cm×9.34 cm~15.23 cm×32.74 cm,均行股前外侧穿支皮瓣游离移植修复,皮瓣切取面积为7.35 cm×10.34 cm~17.63 cm×34.49 cm。观察手术疗效、术后损伤部位功能、感觉恢复情况及术后并发症发生情况。结果:术后随访6个月,皮瓣全部成活,通过皮瓣供血优良度判断,术后优86例,良12例;DASH评分为18~24分,平均(21.46±1.27)分,下肢功能LEFS量表评分为36~52分,平均(43.97±5.57)分。79例患者感觉功能恢复至S3,其余恢复保护性感觉,两点辨别觉为5.3~8.2 mm。供区皮肤饱满红润,无感觉功能障碍。出现并发症共4例(4.08%),其中,感染3例,经抗感染治疗后得到控制;皮瓣边缘坏死1例,经换药或皮瓣移植后愈合,未发生血管危象、感觉障碍等情况。结论:股前外侧穿支皮瓣游离移植修复四肢皮肤缺损疗效显著,能够改善缺损部位的外观和功能,恢复损伤肢体感觉,并发症少,是一种较为理想的选择。Objective To explore the clinical efficacy of anterolateral thigh perforator flap free transplantation on the repair of skin defects of limbs.Methods 98 patients with skin defects of limbs in the hospital were studied from June 2018 to September 2023.The area of skin and soft tissue defects was 6.12 cm×9.34 cm-15.23 cm×32.74 cm.All patients received anterolateral thigh perforator flap free transplantation repair.The area of the flap ranged from 7.35 cm×10.34 cm-17.63 cm×34.49 cm.The surgical efficacy,postoperative functional recovery and sensory recovery of the injured site and occurrence of postoperative complications were observed.Results After 6 months of follow-up,all the flaps survived.According to the blood supply of the flaps,86 cases were excellent and 12 cases were good.The DASH score was 18-24 points,with an average of(21.46±1.27)points.The LEFS score was 36-52 points,with an average of(43.97±5.57)points.The sensory function of 79 patients recovered to S3,and the rest recovered to protective sensation,with a two-point discrimination of 5.3-8.2 mm.The skin of the donor site was plump and ruddy without sensory dysfunction.Complications occurred in 4 cases(4.08%),including 3 cases of infection,which were controlled after anti-infection treatment.Flap edge necrosis occurred in 1 case,which healed after dressing change or flap transplantation.No vascular crisis or sensory disturbance occurred.Conclusion Anterolateral thigh perforator flap free transplantation has significant efficacy on repairing skin defects of limbs.It can improve the appearance and function of the defect site and restore the sensation of the injured limb,and it has few complications and it is an ideal choice.

关 键 词：股前外侧穿支皮瓣 游离移植 四肢 皮肤缺损 修复效果 

分 类 号：R622[医药卫生—整形外科]