改良带蒂股前外侧肌皮瓣修复手部难愈性创面

Modified pedicled anterolateral thigh myocutaneous flap for refractory wounds repair on the hands

目的 探讨改良带蒂股前外侧肌皮瓣修复手部难愈性创面的临床疗效。方法 对2019年1月-2023年7月收治的手部难愈性创面8例,均合并创面感染,且因血管损伤等原因不具备游离皮瓣移植条件,采用改良带蒂股前外侧肌皮瓣移植修复。皮瓣供区直接缝合或者植皮修复,二期行皮瓣断蒂术。结果 术后所有皮瓣均顺利成活,质地柔软,未发生血管危象,肩关节活动无僵硬,患者均保肢成功。结论 改良带蒂股前外侧肌皮瓣血供可靠,抗感染效果良好,舒适性佳,是修复手部难愈性创面的有效临床疗法。

Objective To investigate the clinical effect of modified pedicled anterolateral thigh myocutaneous flap for refractory wound repair on the hands.Methods Between January 2019 and July 2023,8 patients of repair on the hands were repaired with modified pedicled ALT myocutaneous flaps.All patients were complicated with severe infection and severe vascular damage,and free skin flap transplantation could not be performed because of vascular injury.The donor site was closed directly or by skin-grafting repaired.The pedicle division was performed in the second stage.Results All flaps and limbs survived totally with soft texture、no vascular crisis or shoulder stiffness occured.Conclusion The modified pedicled anterolateral thigh myocutaneous flap has reliable blood supply,good anti-infection effect,and improved comfortableness,which is an effective method for repairing refractory wounds complex defects repairs on the hands combined with complex vascular injuries.