收稿日期: 2017-03-20
网络出版日期: 2017-12-30
基金资助
江苏省自然科学基金项目（BK20151203）;江苏省青年医学人才项目（QNRC2016224）
Flow-through anterolateral thigh flap for the treatment of lower limbs wounds
Received date: 2017-03-20
Online published: 2017-12-30
目的 探讨应用血流桥接型股前外侧皮瓣修复下肢皮肤、软组织缺损创面的临床效果。 方法 2014年8月~2016年12月，对12例下肢皮肤、软组织缺损伴骨或内固定外露患者，男8例，女4例，年龄7~66岁，应用血流桥接型股前外侧皮瓣移植修复小腿创面8例、踝部创面3例、足部创面1例，血管缺损长度为6~15 cm（平均10 cm），将旋股外侧动脉降支主干近、远端分别与受区动脉近、远端进行端-端吻合，皮瓣切取面积5 cm×6 cm~32 cm×19 cm，供区直接缝合或以全厚皮片植皮修复。 结果 术后12例皮瓣全部成活，其中1例皮瓣边缘部分坏死，经换药后疤痕愈合，1例皮瓣术后1 d 出现血管危象，经探查后成活，皮瓣均未见静脉回流不足的表现，术后随访3~24个月(平均8个月)，术后桥接血管血流通畅，皮瓣质地优良。 结论 血流桥接型股前外侧皮瓣不牺牲受区主干血管，同时实现覆盖创面的目的，是修复下肢皮肤、软组织缺损的理想方法。
邓伟 , 巨积辉 , 李雷 , 周正虎 , 郑彬兵 , 赵东阳 . 血流桥接型股前外侧皮瓣修复下肢主干血管及软组织缺损创面[J]. 中国临床解剖学杂志, 2017 , 35(6) : 676 -680 . DOI: 10.13418/j.issn.1001-165x.2017.06.017
Objective To investigate the clinical effect of flow-through anterolateral thigh flap in repairing skin and soft tissue defect of lower limbs. Methods From August 2014 to December 2016, 12 cases of lower limbs skin and soft tissue defect with bone or internal fixation exposed patients were treated in our department. They were 8 men and 4 women, aged from 7 to 66 years. Application of flow-through anterolateral thigh flap transplantation of leg wound in 8 cases, 3 cases of ankle wounds, 1 cases of foot wound, The mean artery defect was 10cm in length(from 5 to 16cm),The proximal and distal end of the quadriceps artery were respectively anastomosed to the proximal and distal end of the recipient artery. The area of the flap was from 5 cm×6 cm to 12cm×30cm, The donor site were directly sutured or repaired by full-thickness skin grafting. Results All patients were followed up from 3 months to 24 months (average 8 months); all of the flaps survived completely with a soft tissue texture, and the flow-through artery was unobstructed. One case developed venous thrombosis on the first day of postoperation, one developed local flap necrosis after the operation, which all were treated with operative exploration or dressing change, cured with none of the performance of venous insufficiency. Conclusion The flow-through anterolateral thigh flap is an ideal method to repair the skin and soft tissue defects of the lower limbs, and do not sacrifice the main artery of the recipient area.
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