代偿性应用股前内侧皮瓣修复四肢软组织缺损

Using anteromedial thigh flap as substitution of anterolateral thigh flap in repairing soft tissue defects of limb

目的探讨在行股前外侧皮瓣修复四肢软组织缺损时因血管变异临时变更原设计，代偿性应用股前内侧皮瓣补充替代的临床疗效。方法2005年3月-2013年3月，在行股前外侧皮瓣修复四肢软组织缺损时因血管变异临时改制股前内侧皮瓣修复5例，其中手背创面3例，足背创面2例；缺损面积5cm×8cm×11cm×19cm：本组3例与受区桡动脉、头静脉吻合，2例与足背动脉、伴行静脉吻合；供区直接缝合3例，部分植皮2例。结果本组5例皮瓣全部成活，未出现血管危象，其中1例因切取面积过大，出现皮瓣远端部分坏死．经换药后愈合。随访1～24个月，临床效果满意。结论股前内侧皮瓣可作为股前外侧皮瓣的补充替代，应用股前内侧皮瓣游离移植修复四肢软组织缺损，临床效果满意，值得推广虚丽、

Objective To observe clinical therapy effect of using anteromedial thigh flap as substitution of anterolateral Thigh Flap in repairing soft tissue defects of limb, in case of variation of anterolateral thigh artery is present. Methods From March 2005 to March 2013, 5 cases of anteromedial thigh flap were transplanted to repair soft tissue defect of limb, as substitution of anterolateral thigh flap due to variation of blood vessels. Among the 5 cases, on the dorsum of the hand in 3 cases, on the dorsum of the foot in 2 cases. Size of the wounds varied from 5 cm×8 cm to 11 cm×19 cm. In 3 cases, blood vessels of the flap were anastomosed with the radial artery and the cephalic vein respectively. In 2 cases, blood vessels of the flap were anastomosed with the dorsal artery of foot and its accompanying veins respectively. In 3 cases, wound of the donor site was closed directly. And in 2 cases, partial skin transplantation was need in closing wound of the donor site. Results 5 cases of the anteromedial thigh flap survived successfully, without any blood crisis. Only in 1 case, partial necrosis appeared in distal part of the flap, which healed later after several times of dressing changing. All these cases were followed up for 1 month to 2 years with satisfactory clinical results. Conclusion Anteromedial thigh flap can be used as compensative substitution of anterolateral thigh flap in repairing soft tissue defect of limbs, with satisfactory clinical results. This kind of flap is worthy of popularization and application.