游离胸脐穿支皮瓣或隐动脉穿支皮瓣修复前足软组织缺损

Free transplantation of thoraco-umbilical or saphenous artery perforator flap in the repair of soft tissue defects at the forefoot

目的探讨应用胸脐穿支皮瓣或隐动脉穿支皮瓣修复前足软组织缺损的临床疗效。方法自2011年3月至2012年10月,对9例前足软组织缺损患者分别采用游离胸脐穿支皮瓣(6例)或隐动脉穿支皮瓣(3例)转移修复;创面缺损面积为5 cm×3 cm^8 cm×5 cm。所有患者均行两期手术:一期清创及VSD覆盖;2~4周行二期皮瓣转移修复术。切取皮瓣面积为6 cm×4 cm^10 cm×6 cm。结果所有皮瓣全部成活。随访3~12个月,皮瓣血运良好,受区不臃肿,质地柔软,部分感觉恢复,供区无继发功能障碍。结论采用游离胸脐穿支皮瓣或隐动脉穿支皮瓣修复前足软组织缺损,不牺牲主要血管,术后对外形及功能较满意,是修复前足软组织缺损的良好选择。

Objective To explore the clinical efficacy of free transplantation of thoraco-umbilical or saphenous artery perforator flap in the repair of soft tissue defects at the forefoot.Methods From March 2011 to October 2012,9 patients with soft tissue defects at the forefoot underwent free transplantation of thoraco-umbilical perforator flaps(6 cases)and saphenous artery perforator flaps(3 cases).The area of wound ranged from 5 cm×3 cm to 8 cm×5 cm.All patients underwent two stages of surgery.In the first stage,debridement and VSD coverage was performed.In the second stage,free transplantation of thoraco-umbilical or saphenous artery perforator flap was performed at 2 to 4 weeks later.The area of flap ranged from 6 cm×4 cm to 10 cm×6 cm.Results All flaps survived.During the follow-up from 3 to 12 months,the blood supply of flap was good,recipient site was not swelling,the texture was soft and partial sensory recovered.No secondary dysfunction in the donor site.Conclusion Free transplantation of thoraco-umbilical and saphenous perforator artery flap was a good choice in the repair of soft tissue defects at the forefoot.This method did not sacrifice the primary blood vessels,and patients were satisfied with the appearance and function postoperative.