船形改良拱顶石穿支岛状皮瓣修复跨关节部位软组织缺损

Reconstruction of soft tissue defect across the joint with a modified boat shaped keystone design perforator island flap

目的探讨船形改良拱顶石穿支岛状皮瓣修复跨关节部位软组织缺损的临床效果。方法用改良拱顶石穿支岛状皮瓣修复跨关节部位皮肤及软组织缺损8例,缺损面积为5 cm×7 cm^9 cm×16 cm。在缺损创面周围设计拱顶石样皮瓣,两侧顶角呈90°,头尾两侧包含2个"V-Y"推进皮瓣。跨关节处设计一个连续"V"形皮瓣外形似船,避免影响关节功能。结果所有患者创而均一期愈合。术后随访6~12个月,其形态和功能均满意。结论船形改良拱顶石穿支岛状皮瓣对于跨关节周围的软组织缺损具有良好的修复效果,同时不影响关节功能,值得在临床上推广应用。

Objective To introduce experience in soft tissue defects across joint reconstruction using modified boat-shaped keystone design perforator island flap. Methods Modified flaps were used in 8 patients. The size of defects ranged from 5 cm ×7 cm to 9 cm × 16 cm at the joint region. The flap was designed around the defect with a 90° angle at the two ends of the island flap. This flap consists of two conjoined ＂V-Y＂ advancement flaps at the proximal and distal end. A continuous ＂V＂ shaped flap boat-like shape was designed to avoid the influence of joint function. Results Primary wound healing and satisfactory results was achieved in 8 patients. All patients were satisfied with appearance and function during 6 to 12 months follow-up period. Conclusion Soft tissue defects across joint reconstruction using modified boat-shaped keystone design perforator island flap is an effective method and protects joint function. It should be considered for clinical application.