旋髂浅动脉岛状皮瓣修复会阴部创面

Application of Superficial Iliac Circumflex Artery Island Flaps in Repairing Defects of Perineal Region

目的探讨旋髂浅动脉岛状皮瓣修复会阴部创面的可行性及临床效果。方法 2004年7月至2009年3月,设计旋髂浅动脉轴型皮瓣,旋转180°后修复各种原因所致会阴部创面8例,供区植皮或局部皮瓣转移后闭合创面。术后定期随访,观察皮瓣成活情况及供瓣区愈合情况。结果 1例皮瓣出现静脉回流障碍,经拆除蒂部的部分缝线后缓解;1例皮瓣掀起后远端血运欠佳,遂改行皮瓣延迟术,二期转移修复会阴缺损;其余皮瓣均一期成活,未出现切口裂开、感染、皮瓣下血肿和皮瓣坏死等并发症。术后随访8个月至5年,移植皮瓣外观及形态良好,无明显臃肿、色素沉着;供瓣区无明显继发畸形。结论旋髂浅动脉轴型皮瓣血供可靠、供区易修复,可大范围转移,是修复会阴部原发或继发创面的理想方法。

Objective To evaluate the clinical effects of superficial iliac circumflex artery（SICA） island flaps in repairing soft tissue defects of perineal region.Methods SICA island flaps were elevated and transposed to repair tissue defects of perineal region in 8 cases.Further local flaps transposition or splint thickness skin grafting were applied to recover the donor sites.Results Venous congestion happened in one case,and skin flap delay was performed in another case.All the flaps survived eventually and achieved satisfactory results in eight months to five years follow-up.Conclusion The use of SICA island flaps in the closure of soft tissue defects in perineal region is easy and practical,with the advantages of stable blood vessels,high survival rate and few complications.