膝上逆行皮瓣修复窝部瘢痕挛缩

Investigation of a retrograded supra-genicular flap for treatment of scarring contraction of popiteal fossa

目的 探讨膝上逆行皮瓣血供及临床应用的可靠性。方法 对 8具 16侧成人尸体下肢新鲜标本灌注后 ,解剖观察大腿中下段皮肤血供情况 ,并应用膝上逆行皮瓣 5 6块修复 5 2例窝部瘢痕挛缩畸形。结果 膝上前内、外侧区皮肤有丰富的血管网 ,并与髌周围血管网广泛吻合。于该区设计向上的逆行皮瓣 ,修复窝部瘢痕挛缩松解后创面 ,5 6块皮瓣成活良好 ,远期效果满意。结论 膝上逆行皮瓣修复窝部瘢痕挛缩是一种安全可靠的方法。

Objective To investigate the blood vascular distribution of supra-genicular flap and to apply the retrograded supra-genicular flap for reconstructive surgery. Methods Eight fresh adult cadavers with 16 lower extremities were used for the study, by means of injecting the media of red latex into the main artery of the limb. The skin vascular architecture on the lower two thirds of each thigh was observed to decide the blood supply of this region. Fifty-two patients were also used to treat the scarring contraction of the popiteal fossa with 56 of the retrograded supra-genicular flaps, and long-term follow-ups were carried out. Results From this study, it was found that there are rich blood vascular networks of the skin above the knee anteriorally, laterally and medially. The abundant vascular anastomoses were also found around the knee. The clinical application of the retrograded supra-genicular flap was successfully carried out for the treatment of the scarring contraction of the popiteal fossa. All of the flaps were survived well. Long-term results were satisfactory. Conclusion The above mentioned flap is a safe and effective flap for repair the defect of the popiteal fossa.