游离股前外侧皮瓣联合股外侧肌瓣的临床应用

Clinical Application of Free Anterolateral Thigh Flap Combination with Vastus Lateralis Flap

目的:总结游离股前外侧皮瓣联合股外侧肌瓣的临床应用结果。方法:用游离股前外侧皮瓣联合股外侧肌瓣构成的双叶瓣,修复8例手与足部软组织缺损。肌瓣行一期中厚网状游离植皮,皮瓣供区直接缝合,双叶瓣的血管蒂与供区的血管行端端吻合。结果:所有双叶瓣术后经过顺利,全部成活,取得了满意的临床效果。1例肌瓣术后发生远端尖部小片植皮坏死,经交换敷料逐渐自行愈合。1例发生供区血肿。供区没有发生明显的功能障碍。结论:双叶瓣由旋股外侧动脉降支为血供,具有血运丰富、血管解剖恒定、血管蒂长以及切取容易等优点,适宜修复手和足部的软组织缺损。

Objective：To summarize clinical application of free anterolateral thigh flap （FATF） combining with vastus lateralis flap （VLF）. Methods：Bilobed flap made from FATF and VLF were used to treat 8 cases of soft tissue lession in hands or foot. The immediate coverage of muscle flaps was performed by a meshed split- thicknss skin graft. The thigh donor site was closed directly. The vascular pedicles of biloved flap were anastomosed end-to-end to recipient site vascular. Results：All bilobed flaps were survived completely with satisfactory clinical results. One muscle flap developed minor nec rosis at distal tip site of skin graft, but the wound healed gradually with daily wound dressings exchanging. A hematoma at donor site was observed in 1patient but without obviously functional disturbance. Conclusion：The blood supply of bilobed flap is nourished from quadriceps artery of femur. Bilobed flap has the advantage of sufficient blood supply, vessle anatomical location constancy, long vascular pedicle and easily obtaining, so it is suitable to repair soft tiussue lession in hands and foot.