游离股前外侧穿支皮瓣在四肢软组织缺损中的应用研究

Anterolateral thigh perforator free flaps for reconstruction of four limbs soft tissue defects

目的观察游离股前外侧穿支皮瓣修复四肢软组织缺损的临床效果。方法选择2013年4月至2016年6月收治的四肢外伤性软组织缺损患者24例，其中男性18例，女性6例；年龄34～73岁，平均年龄53岁；皮瓣受区位置：前臂1例，小腿15例，足部8例；切取皮瓣大小：6cm×10cm-10cm×22cm，均采用游离股前外侧穿支皮瓣修复创面，供区直接缝合，术后观察皮瓣血运、质地、形态，所有病例获得随访，随访时间6个月～2年。结果24例游离股前外侧穿支皮瓣全部存活，术后未出现血管危象、皮瓣部分坏死、创面感染难以控制等严重并发症，供、受区切口均r期愈合，大腿及受区功能及形态良好。结论游离股前外侧穿支皮瓣是修复四肢软组织缺损的一种理想方法，值得临床推广应用。

Objective To explore the therapeutic effect of anterolateral thigh perforator free flaps for reconstruction of four limbs soft tissue defects. Methods Among 24 patients treated with anteriolateral thigh perforator free flap for traumatic soft tissue defects from April 2013 to June 2016, 18 cases were male, 6 cases were female; the age of the 24 patients ranged from 34 to 73 years old, and the average age was 53 years old. The damaged part： 1 cases in forearm, 15 cases in shank, and 8 cases in foot. The size of those soft tissue defects was from 6 cm × 10 cm to 10 cm× 22 cm. Free anterolateral thigh perforator flap was applied in all cases for the repair of the wound, followed by direct suture in the donor site. Postoperative observation included the blood supply, texture, and shape of the flap. All of the cases were followed up, the duration of follow-up ranged from 6 months to 2 years. Results Free anterolateral thigh perforator flap all survived in 24 cases, without any serious postoperative complications, such as vascular crisis, partial necrosis, and unmanageable wound infection. The wounds and incisions at donor sites healed by first intention, besides, both the appearance and the fimction were well based on follow-up results. Conclusion Free anterolateral thigh perforator flap is a kind of effective therapeutic measure to treat soft tissue defect in the limb, worthy of clinical application.