应用股前外侧皮瓣修复巨大体表肿瘤切除后组织缺损

Repair of defect induced by removal of body surface oversized malignancy with free anterolateral femoral skin flap

目的探讨应用游离股前外侧皮瓣修复巨大体表肿瘤切除后组织缺损的疗效。方法2007年4月至2010年11月．采用吻合血管的股前外侧皮瓣修复巨大体表恶性肿瘤切除后创面9例，其中6例为头部及四肢烧伤瘢痕引起的鳞状细胞癌，3例腹部复发巨大隆突性皮纤维肉瘤。肿瘤切除后缺损面积19cm×15cm～24cm×21cm，切取皮瓣面积20cm×16cm～25cm×22cm。术后3例进行放疗。结果9例皮瓣全部成活。术后1例皮瓣出现远端浅表坏死，经换药及抗感染治疗愈合。受区未发生腹壁疝等手术并发症。供区植皮一期愈合，无运动受限等并发症。术后随访12～24个月，缺损修复部位形态和功能良好．肿瘤切除后无1例复发。结论股前外侧皮瓣是修复巨大体表恶性肿瘤切除后软组织缺损比较理想的皮瓣。

Objective To study the clinical efficacy of free anterolateral femoral skin flap on the repair of skin and subcutaneous soft tissue defects caused by excision of oversized malignant tumour in the skin. Methods A retrospective review was performed of free anterolateral femoral skin flap reconstruc- tions for oversized malignant tumor cut on body surface since April 2007 to November 2010. There were 6 patients with head and limb squamous cell carcinoma because of burn scar and 3 patients with recurrence of dermatofibrosarcoma protuberans in wall of belly. The area of soft tissue defects ranged from 19 cm ~ 15 em to 24 cm ~ 21 cm, and skin flaps was 20 cm ~ 16 cm to 25 cm ~ 22 em in size. Three cases received radio therapy after operation. Results Nine flaps survived perfectly, one flap survived with partial necrosis and healed after changing dressings. No complications were observed in the donor site, including wound dehiscence, hernia and weakness. Follow-up survey of 12-24 months after the operation showed that the appearance and function in the repaired sites were normal, and norecurrence of the tumors. Condusion Free transplantation of anterolateral femoral skin flap is relatively an ideal operative type for the repair of soft tissue defects caused by excision of oversized malignant tumour in the skin.