游离股前外侧皮瓣修复颜面部（头部）大面积皮肤缺损伴颅骨外露

The therapy of the large skin defect with skull exposure of face （or head） with free anterolateral thigh flap

目的 探讨游离股前外侧皮瓣修复颜面部（头部）大面积皮肤缺损伴颅骨外露的方法及疗效.方法 2010年5月-2015年9月,对8例颜面部（头部）大面积皮肤缺损伴颅骨外露患者采用游离股前外侧皮瓣修复.术中设计皮瓣面积：8 cm×12 cm-16 cm×18 cm.供区行中厚皮移植、减张缝合或接力皮瓣移植修复.结果 术后7例皮瓣全部成活,创面Ⅰ期愈合;1例皮瓣远端边缘部分坏死,经后期换药处理后,创面愈合.8例术后均获得随访,随访时间6个月-3年,其中3例皮瓣臃肿,术后3个月行去脂整形术,余5例皮瓣色泽、质地恢复良好,效果满意.结论 股前外侧皮瓣具有恒定的血供系统和皮神经,且获取皮瓣面积大,是临床治疗颜面部（头部）大面积皮肤缺损伴颅骨外露的有效方法之一.

Objective To study the technical feasibility and clinical effectiveness of using free anterolateral thigh flap for repairing the large skin defect with skull exposure of face （or head）. Methods From May 2010 to September 2015, 8 cases of the large skin defect with skull exposure of face （or head） were treated with free anterolateral thigh flap, and the sides of the flaps were harvested from 12 cm×8 cm to 18 cm×16 cm, and the donor sites were covered with full thickness skin or directly tension-free sutured or covered with relay flap. Results 7 cases of flaps survived completely, and the wound healed well. 1 case had distal necrosis, and the wounds healed after the post-dressing treatment. The follow-up period were from 6 months to 3 years, 3 cases of the flaps were bloated and rowed fat removed plastic operation after 3 months. The color and texture of the flaps were matched with the affected area in the rest of 5 cases. Conclusion Free anterolateral thigh flap has a constant blood supply system and cutaneous nerve, and the area of the flap is large enough, and the expected results are easy to get, so the free anterolateral thigh flap is one of the effective methods to repair the large skin defect with skull exposure of facial （or head）.