吻合血管的胸脐皮瓣修复下肢巨大软组织缺损的临床观察

Repair of the large soft tissue defects on the lower extremity with vascular thoracoumbilical flaps

目的应用吻合血管的胸脐皮瓣修复下肢巨大软组织缺损的临床观察。方法临床应用脐旁皮瓣修复下肢不同部位的软组织缺损23例。修复部位：胫前10例，足背6例，足底5例，踝2例。结果皮瓣完全成活，术后随访2个月～3年，成活的皮瓣外观良好。结论胸脐皮瓣为腹壁下动脉供血，血运丰富，血管解剖恒定，血管蒂长，可切取面积大且易于切取，适宜修复下肢软组织缺损，尤其适用于巨大面积的纵向软组织缺损。

Objective To explore the clinical results of repair of the large soft tissue defects on the lower extremity with vascular thoracoumbilical flaps. Methods Twenty-three cases of the large soft tissue defects on the lower extremity were repaired with vascular thoracoumbilical flaps. The sites of repair： 10 cases of anterior tibial area,6 cases of back of foot,5 cases of the plantar area,2 cases of posterior malleolus region. Results Follow-up 2-36 months. All thoracoumbilical flaps survived,and the appearance was satisfactory. Conclusion The thoracoumbilical flap is nourished by inferior epigastrica artery, which is highly vascularized, with a constant vascular anatomy and a long vascular pedicle, so the disection of the flaps is easy and large area of flap could be obtained. It is suitable for repairing the large soft tissue defects on the lower extremity.