游离股前外侧皮瓣静脉危象的防治对策

Countermeasures to Anterolateral Thigh Free Flap Venous Crisis

目的探讨股前外侧皮瓣静脉危象的形成原因及处理方法 ,提高皮瓣移植成功率。方法对2009年8月至2011年10月移植的股前外侧皮瓣20例进行回顾性分析,其中10例术中增加吻合伴行静脉的远端或股外侧浅静脉,增加第二套静脉回流系统,另10例单纯吻合伴行静脉近端。结果单纯吻合伴行静脉近端的一组出现静脉危象3例,皮瓣经探查后均成活,增加静脉回流的一组皮瓣无静脉危象发生。结论术中重建第二套静脉回流系统,术后严密的监测,是皮瓣避免出现静脉危象的关键。

Objective To explore the causes and treatment methods of anterolateral thigh flap venous crisis so as to improve the success rate of flap transplantation.Methods Make retrospective analysis on transplantation of anterolateral thigh flap in 20 cases from August 2009 to October 2011,including 10 cases of intraoperation or exploration increasing accompanying vein distal end or the superficial lateral femoral vein,adding second set of venous return system.And 10 cases of simple anastomosis accompanying vein.Results 3 cases of flap venous crisis were survival after exploration,there was no venous crisis occurred to the flap increased venous return system,postoperative appearance is satisfied.Conclusion The reconstruction of second set of the venous drainage system together with close postoperative monitoring,is the key to avoid flap’s venous crisis.