超回流技术在逆行股前外侧皮瓣中的应用

Application of reverse anterolateral thigh flap with venous superdrainage

目的：探讨超回流技术在逆行股前外侧皮瓣修复膝关节周围创面中的应用效果。方法2010年2月至2015年8月，应用逆行股前外侧皮瓣修复膝关节周围创面7例。创面伴骨及关节韧带外露，缺损范围15 cm x6 cm -20 cmx10 cm。在行股前外侧带蒂皮瓣逆行移位修复创面的同时，应用“外增压超回流”原理，将旋股外侧动脉降支伴行静脉起始端与创面周围静脉吻合，有效改善皮瓣静脉回流。皮瓣切取范围17 cmx8 cm -23 cmx12 cm。供区直接缝合或游离全厚皮片移植修复。结果7例皮瓣全部成活，未发生血管危象，皮瓣无肿胀。术后随访时间3-16个月，平均随访8个月。皮瓣血运好，外观饱满，质地柔软，色泽与受区相似，无色素沉着，供区无功能障碍。结论采用超回流技术，有效地解决了逆行股前外侧皮瓣静脉回流，提高了皮瓣成活率。

Objective To investigate the application effect of venous superdrainage to repair the wound around the knee joint with reverse anterolateral thigh flap. Methods From February, 2010 to August, 2015, 7 patients with wound around the knee joint were treated with reverse anterolateral thigh flap. The size of wound ranged from 15 cm x6 cm to 20 cm x 10 cm..Which bone and joint ligament exposed to air..With outside pressure and venous superdrainage , it can effectively solve the problem of venous stagnation , anastomosing their veins ac-companied with the lateral femoral circumflex artery descending branch with the veins in the neighborhood , when repaired the wound with reverse anterolateral thigh flap..The size of the flap ranged from 17 cm x8 cm to 23 cm x12 cm. The donor sites were sutured directly or covered with full-thickness skin graft. Results All the 7 flaps sur-vived completely without vascular crisis and swelling. These flaps had abundant blood supply an good appearance , soft texture, normal skin color, no pigmentation. Conclusion With venous superdrainage, it can effectively solve the problem of venous stagnation of reverse anterolateral thigh flap , and improve the survival rate of flaps.