以旋股外侧动脉穿支和旋髂浅动脉穿支供血的联体穿支皮瓣修复儿童四肢创面  

Reconstruction of limb wounds in children with a combined perforator flap by dual perforators of lateral circumflex femoral artery and superficial circumflex iliac artery

作　　者：周健 郑玉岑 陈伟 常树森 魏在荣 聂开瑜 ZHOU Jian;ZHENG Yucen;CHEN Wei;CHANG Shusen;WEI Zairong;NIE Kaiyu(Department of Plastic Surgery and Burns,the Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China)

机构地区：[1]遵义医科大学附属医院烧伤整形外科,遵义563003

出　　处：《中华显微外科杂志》2024年第6期620-624,共5页Chinese Journal of Microsurgery

基　　金：省部共建协同创新中心项目(教科技厅函[2020]39号)。

摘　　要：目的探讨以旋股外侧动脉穿支和旋髂浅动脉穿支供血的联体穿支皮瓣修复儿童四肢创面的可行性和临床效果。方法采用回顾性病例系列研究分析。2019年2月至2023年6月,遵义医科大学附属医院烧伤整形外科应用以旋股外侧动脉穿支和旋髂浅动脉穿支供血的联体穿支皮瓣修复儿童四肢创面6例,其中男孩4例,女孩2例。年龄2~12岁,平均6.8岁,软组织缺损面积为19.0 cm×5.0 cm~28.0 cm×6.0 cm,皮瓣大小20.0 cm×6.0 cm~30.0 cm×7.0 cm,与皮瓣穿支的血管吻合方法:肢体近端血管蒂采用端-侧吻合,肢体远端血管蒂采用端-侧或端-端吻合,皮瓣受区Ⅰ期缝合。术后定期通过门诊、电话或微信进行随访,观察患者创面愈合、皮瓣成活及功能恢复情况。结果6例皮瓣均顺利成活。供区术后1例出现切口部分裂开,经Ⅱ期清创缝合后愈合,余5例供区均Ⅰ期愈合。所有患者随访时间为6~16个月,平均13.7个月。皮瓣成活好,无明显臃肿,外形满意,未出现破溃、感染等并发症,供区遗留线形瘢痕,边缘柔软,无明显挛缩。四肢功能均未受影响。结论以旋股外侧动脉穿支和旋髂浅动脉穿支供血的联体穿支皮瓣可切取长度长,皮瓣血供可靠,可以一次性覆盖儿童四肢较长的大面积软组织缺损,临床效果好。Objective To explore the feasibility and clinical effect of a combined perforator flap that was perfused by dual perforators of lateral circumflex femoral artery and superficial circumflex iliac artery in reconstruction of limb wounds in children.Methods A retrospective study was conducted on the childre treated in the Department of Plastic Surgery and Burms,the Affiliated Hospital of Zunyi Medical University from February 2019 to June 2023.Limb wounds of 6 children were treated by combined perforator flaps that carried dual perforators of lateral circumflex femoral artery and superficial circumilex iliac artery.The children were 4 boys and 2 girls of 2-12 years with an average of 6.8 years.The sizes of defect weres 19.0 cm×5.0 cm-28.0 cm×6.0 cm and all were reconstructed with the combined perforator flaps sized 20.0 cm×6.0 cm-30.0 cm×7.0 cm.Proximal vessels of the limb defect were end-to-side anastomosed with the pedicle vessels carried by the flap,and distal vessels of the limb defect were end-to-side or end-to-end anastomosed with the pedicle vessels carried by the flap.The flap recipient sites were sutured in stage I surgery.After the surgery,regular follow-ups were carried out at outpatient clinics,and via telephone and WeChat reviews.Wound healing,flap survival and functional recovery were observed.Results All 6 flaps survived successfully.One donor site had a partial rupture,and healed after stage II debridement and sutures.The remaining 5 donor sites all achieved a stage I healing.All children were entered the postoperative follow-up for 6-16 months,with an average of 13.7 months.All flaps survived well without obvious swelling,and in satisfactory appearance without complication such as a rupture or an infection.Linear scars were left in the donor sites with soft edges without obvious contractures.Limb functions were not affected.Conclusion The combined perforator flap perfused by dual perforators of the lateral circumflex femoral artery and the superficial circumflex iliac artery has an extended leng

关 键 词：旋股外侧动脉穿支 旋髂浅动脉穿支 联体穿支皮瓣 儿童 四肢 显微外科技术 

分 类 号：R726.8[医药卫生—儿科]