股前外侧皮瓣游离移植在大面积四肢软组织缺损修复中的应用

Application of anteriolateral skin flap of thigh free grafting in repairment of large area soft tissue defect in limbs

目的探讨股前外侧皮瓣游离移植在修复大面积四肢软组织缺损中的临床应用。方法 2003年5月至2011年8月,选用股前外侧皮瓣游离移植修复大面积四肢皮肤软组织缺损的患者56例。其中男39例,女17例;年龄17～76岁,软组织缺损面积最小为8 cm×10 cm,最大为16 cm×25 cm,皮瓣面积最小为9 cm×11 cm,最大为16 cm×27 cm。术后随访5～38个月,测评皮瓣的感觉、血运和外形等,对临床资料进行综合分析。结果本研究56例,皮瓣完全成活53例;3例边缘部分坏死,经换药和皮片移植而愈合;56例中随访到48例,随访时间5～38个月,平均15.2个月,皮瓣恢复保护性感觉,两点分辨觉为11～13 mm左右,质软有弹性,外形稍显臃肿,患者基本满意,恢复泌汗功能。皮瓣供区对下肢功能无明显影响。结论修复大面积四肢软组织缺损可以优先选用股前外侧皮瓣游离移植术。

Objective To investigate the clinical application of anteriolateral skin flap of thigh free grafting in repairment of large area soft tissue defect in limbs.Methods From May 2003 to August 2011,56 cases of large area soft tissue defect were repaired by anteriolateral skin flap of thigh free grafting.Among them,there were 39 males and 17 females,ranged from 17~76 years old.The areas of soft tissue defect were from 8 cm×10 cm to 10 cm×25 cm,and the areas of flaps were from 9 cm×11 cm to 16 cm×27 cm.The follow-up time was 5-38 months,the shape,sense and blood circulation of flaps were observed.The clinical data were analyzed comprehensively.Results Among the 56 cases,the flaps totally survived in 53 patients,partially survived in 3 cases,finally survived by change of dressing and free skin grafting.In all 56 cases,48 cases got 5-38 months following-up,15.2 months in average.The appearance,thickness and texture of the flaps were good.Their perspiration function and protective sense were satisfactory.Two point discrimination was 11-13 mm.The skin grafting of donor site had no effect on function of lower extremity.Conclusion Anteriolateral skin flap of thigh free grafting is an ideal method for repairing the large area soft tissue defect in limbs.