逆行股前外侧筋膜脂肪瓣修复膝周创面

Repair of defects around the knee with reversed anterolaterai thigh adipofascial flap

目的探讨逆行股前外侧筋膜脂肪瓣修复膝周围创面的临床应用。方法自2006年7月至2007年5月，采用逆行的股前外侧筋膜脂肪瓣修复膝及小腿上端创面5例。术前常规用多普勒超声探测穿支点并标记，皮瓣大小为6cm×8cm～12cm×13cm，将穿支点包括在内，切断旋股外侧动脉的近心端，游离其远心端达筋膜脂肪瓣转移至膝及小腿上端创面，筋膜脂肪瓣上面移植中厚皮片。结果所有的筋膜脂肪瓣均完全成活，1例皮片部分坏死，换药后愈合，供区无并发症发生。结论逆行股前外侧筋膜脂肪瓣可以提供血管蒂较长的薄组织瓣，对供区的损伤小，最大程度保持了供区的外形。是临床修复膝周围创面的一个良好选择。

Objective To analyse clinical application of reversed anterolateral thigh adipofascial flap in repair of defects around the knee. Methods Reversed anterolateral thigh adipofascial flap was employed to repair defects of knee and upper shank in five patients from July 2006 to April 2007. The perforator arteries were detected and labelled with a hand held Doppler flowmeter before operation. The size of flaps containing perforator artery ranged from 6cm×8cm to 12cm×13cm. After the descending branch was severed at the bifurcation of the lateral circumflex femoral artery, the flaps were elevated distally to cover the defects of the knee and upper part of the shank. A split thickness graft was harvested to cover the flap. Results All the reversed anterolateral thigh adipofascial flaps survived well, with no complications occurred in donor site. Partial graft necrosis occurred in one patient and healed after conservative wound dressing change. Conclusion The reversed anterolateral thigh adipofascial flap is a good choice for repair of defects around the knee, for it can provide long thin vascular pedicle and maintain contour of the donor cite.