1260例游离股前外侧皮瓣移植术后引起皮瓣坏死的相关因素分析

doi:10.13418/j.issn.1001-165x.2024.5.05

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中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (5) : 517-522. DOI: 10.13418/j.issn.1001-165x.2024.5.05

股前外侧皮瓣

1260例游离股前外侧皮瓣移植术后引起皮瓣坏死的相关因素分析

陶先耀，　薛明宇，　糜菁熠，　施海峰，　陆征峰，　赵刚
强力，　周晓，　张志海，　许亚军，　芮永军*

作者信息 +

Analysis of related factors of postoperative necrosis in 1260 cases of free anterolateral thigh flap transplantation

Tao Xianyao, Xue Mingyu, Mi Jingyi, Shi Haifeng, Lu Zhengfeng, Zhao Gang, Qiang Li, Zhou Xiao, Zhang Zhihai, Xu Yajun, Rui Yongjun*

Author information +

文章历史 +

摘要

目的　对我院游离股前外侧皮瓣坏死的影响因素进行总结，并对相关的影响因素进行探讨和分析。方法　收集2014年6月至2024年6月我院手术的1260例游离股前外侧皮瓣的相关信息，对23个相关的影响因素进行分析，包括患者特点、术前因素、术中因素和术后因素。将这些影响因素与皮瓣坏死结果进行单因素分析和多变量Logistic回归分析。结果 1260例游离股前外侧皮瓣成活1167例（92.6%），坏死93例（7.4%）。经统计学分析得出：静脉吻合数量、皮瓣感染、皮瓣下血肿、血管危象与游离股前外侧皮瓣的坏死密切相关。结论静脉血管吻合数(≥2)会增加血液回流，皮瓣更易成活;术中彻底清创、精确止血和充分的引流会减少皮瓣感染和血肿的发生，可以减少皮瓣坏死;术后及时发现动静脉血管危象并对应的处理，可以提高皮瓣成活率。

Abstract

Objective To summarize the influencing factors of free anterolateral thigh flap necrosis in our hospital, and to discuss and analyze the related influencing factors. Methods A total of 1260 free anterolateral femoral flaps operated in our hospital from June 2014 to June 2024 were collected, and 23 related influencing factors were analyzed, including patient characteristics, preoperative factors, intraoperative factors, postoperative factors. Univariate analysis and multivariate logistic regression analysis were performed on these influencing factors and the results of flap necrosis. Results 1260 free anterolateral thigh flaps survived in 1167 cases (92.6%) and necrotic in 93 cases (7.4%). Statistical analysis showed that the number of venous anastomosis, flap infection, subflap hematoma, vascular crisis were closely related to the necrosis of the free anterolateral femoral flap. Conclusions Venous vascular anastomosis (≥2) can increase blood return and make the flap more viable, and thorough debridement, precise hemostasis and adequate drainage during surgery can reduce the occurrence of flap infection and hematoma, reduce flap necrosis, and timely detection and treatment of arteriovenous crisis after surgery can improve the survival rate of flap.

导出引用

陶先耀, 薛明宇, 糜菁熠, 施海峰, 陆征峰, 赵刚, 强力, 周晓, 张志海, 许亚军, 芮永军. 1260例游离股前外侧皮瓣移植术后引起皮瓣坏死的相关因素分析[J]. 中国临床解剖学杂志. 2024, 42(5): 517-522 https://doi.org/10.13418/j.issn.1001-165x.2024.5.05

Tao Xianyao, Xue Mingyu, Mi Jingyi, Shi Haifeng, Lu Zhengfeng, Zhao Gang, Qiang Li, Zhou Xiao, Zhang Zhihai, Xu Yajun, Rui Yongjun. Analysis of related factors of postoperative necrosis in 1260 cases of free anterolateral thigh flap transplantation[J]. Chinese Journal of Clinical Anatomy. 2024, 42(5): 517-522 https://doi.org/10.13418/j.issn.1001-165x.2024.5.05

中图分类号： R616.2

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