股前外侧穿支分叶皮瓣修复足部皮肤软组织缺损

Anterolateral thigh perforator lobulated flap to repair foot skin and soft tissue defects

目的探讨应用股前外侧穿支分叶皮瓣修复足部皮肤软组织缺损的手术方法及临床疗效。方法2019年9月-2021年9月,采用股前外侧穿支分叶皮瓣修复足部皮肤软组织缺损8例。足部创面面积:9.0 cm×9.0 cm~12.0 cm×15.0 cm,通过设计分成双叶皮瓣。单个皮瓣切取面积:4.0 cm×8.0 cm~6.5 cm×15.5 cm;皮瓣游离后与受区血管吻合,股前外侧供区直接拉拢闭合。结果术后6例伤口一期愈合,皮瓣成活良好,另2例伤口感染经后期换药愈合;术后皮瓣无血管危象发生,8例均获5~24个月随访,平均12个月。患者皮瓣柔软,质地好,供区损伤小。结论应用股前外侧穿支分叶皮瓣通过合理设计及切取,可变皮瓣长度为宽度便于将大腿供区直接闭合避免植皮;修复足部创面临床效果良好,是一种足部较大面积或邻近两个创面皮肤缺损修复的较好方法。

Objective To explore the surgical methods and the curative effect of anterolateral thigh perforator lobulated flap for repairing foot skin and soft tissue defects.Methods From September 2019 to September 2021,8 cases with foot skin and soft tissue defects were treated by free anterolateral thigh perforator lobulated flap.Foot wound area was 9.0 cm×9.0 cm~12.0 cm×15.0 cm,lobulated flap area was cut 4.0 cm×8.0 cm~6.5 cm×15.5 cm;the donor area of the thigh was directly closed.Results Among 8 patients,6 wounds of the free flap healed in the first stage and the flap survived well.Two cases had delayed wound healing due to infection.No vascular crisis occurred in the flap after operation.8 patients were followed up for 5-24 months,with an average follow-up of 12 months.The flap was soft and good in texture,and the donor site was less damaged.Conclusion The application of the anterolateral femoral perforator flap is a good way of repairing a large area of the foot or two adjacent traumatic skin defects,as the flap length can be reduced to a width that facilitates direct closure of the thigh donor area to avoid skin grafting.