目的 探讨基于“泳裤供区”理念设计旋髂浅动脉穿支皮瓣（SCIP)修复四肢皮肤软组织缺损的可靠性与临床疗效。 方法 回顾性分析自2019年9月至2020年6月我院创伤骨科收治的四肢皮肤软组织缺损患者38例。其中男性26例，女性12例。损伤部位：手部缺损17例，足部缺损21例。软组织缺损面积：1.3 cm×1.7 cm~12 cm×8 cm。所有患者均采用游离SCIP进行修复。皮瓣切取面积：1.6 cm×2.1 cm~15 cm×11 cm。术后常规给予抗感染、抗凝、抗痉挛、保温等治疗并定期随访。 结果 38例皮瓣均得到有效随访8~14月，平均10.4月，所有皮瓣均顺利成活。2例皮瓣术后出现血管危象，1例给予活血解痉等处理后顺利成活，1例抬高患肢后自行缓解。余皮瓣血液循环良好，外形与功能恢复满意，供区仅留存线状瘢痕。 结论 “泳裤供区”理念下设计游离SCIP修复四肢软组织缺损，其综合了受区移植后的功能与外形，亦兼顾了供区位置与美观程度，且并发症少。为修复四肢软组织缺损的较佳选择，值得临床进一步推广应用。
关键词：
旋髂浅动脉； ; ; 穿支皮瓣； ; ; 泳裤供区； ; ; 四肢； ; ; 软组织缺损
Objective To investigate the reliability and clinical efficacy of the superficial circumflex iliac artery perforator flap (SCIP) designed on the concept of "swim trunk donor site" in repairing skin and soft tissue defects of extremities. Methods Thirty-eight patients with skin and soft tissue defects of extremities admitted to the department of Traumatology and Orthopedics of our hospital from September 2018 to June 2020 were analyzed retrospectively, including 26 males and 12 females. The injury site included hand defects in 17 cases and foot defects in 21 cases. Soft tissue defect area was 1.3 cm×1.7 cm~12 cm×8 cm. All patients were repaired with free SCIP. The area of the skin flap was 1.6 cm×2.1 cm~15 cm×11 cm. Anti-infection, anticoagulation, anti-spasm, and heat preservation treatments were routinely given after the operation and regular follow-ups were performed. Results Thirty-eight cases of skin flaps were followed up for 8-14 months, with an average of 10.4 months; all skin flaps survived successfully. Two cases had vascular crisis after flap operation, and 1 case survived smoothly after activating blood circulation and antispasmodic treatment, one case relieved spontaneously after raising the affected limb. The remaining flap had good blood circulation, and the appearance and function recovered satisfactorily. Only linear scars remained in the donor area of the flap. Conclusions Under the concept of "swimming trunks supply area", free SCIP is designed to repair soft tissue defects of limbs, which integrates the function and appearance of the transplanted area, and also takes into account the location and aesthetic degree of the donor area, with few complications. As a better choice for repairing soft tissue defects in limbs, it is worthy of further clinical application.
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