逆行股前外侧带蒂皮瓣修复膝关节周围皮肤缺损

Repair of skin defects around knee joint with retrograde anterolateral thigh pedicled flaps

目的探讨逆行股前外侧带蒂皮瓣修复膝关节周围皮肤缺损的临床效果。方法回顾性分析2019年1月至2023年12月我院应用逆行股前外侧带蒂皮瓣修复膝关节周围皮肤缺损的10例患者的临床资料。膝关节周围皮肤缺损面积为(5 cm×6 cm)~(10 cm×13 cm)。结果本组手术均顺利完成,皮瓣大小(6.0 cm×7.5 cm)~(12.0 cm×15.5 cm)。手术时间2~3 h,平均2.5 h;出血量150~250 mL,平均180 mL;住院时间12~18 d,平均14 d。术后皮瓣成活良好,无血管危象发生。供区伤口直接闭合6例,游离植皮4例,均一期愈合。1例患者供区植皮区瘢痕轻度挛缩。本组10例均获随访,随访时间2个月~2年。皮瓣外形满意,色泽接近正常,质地弹性良好,两点辨别觉6~8 mm,平均7 mm。患者膝关节活动基本正常,行走正常。结论应用逆行股前外侧带蒂皮瓣修复膝关节周围皮肤缺损,具有血管恒定、血管蒂长、皮肤质地相近等优点,是修复膝关节周围皮肤缺损创面的理想选择。

Objective To explore the clinical effect of retrograde anterolateral thigh pedicled flaps for repairing the skin defects around the knee joint.Methods A retrospective analysis was conducted in 10 cases with skin defects around knee joint which treated with retrograde anterolateral thigh pedicled flaps from January 2019 to December 2023 in our hospital.The area of skin defect around the knee joint ranged from 5 cm×6 cm to 10 cm×13 cm.Results The operation was successfully accomplished in all 10 cases,and the flaps sized from 6.0 cm×7.5 cm to 12.0 cm×15.5 cm.The operation time was 2 to 3 hours(mean,2.5 hours),the blood loss volume was 150 to 250 mL(mean,180 mL),and the hospitalization time was 12 to 18 days(mean,14 days).All flaps survived well without vascular risk.The donor site wounds were closed directly in 6 cases and performed free skin grafting in 4 cases,and all were healed in primary stage.Mild scar contracture of skin grafting of donor site was found in one case.All cases were followed up for 2 months to 2 years.The skin flaps achieved satisfactory appearance,similar color,good texture and flexibility,with two-point discrimination of 5 to 8 mm(mean,7 mm).The knee joint function was restored with nearly normal movement and walking.Conclusion The retrograde anterolateral thigh pedicled flap grafting is an ideal choice for repairing the skin defect around the knee joint due to the advantages of constant blood vessels,long vascular pedicles and similar color and texture to normal tissue.