游离肌皮瓣修复下肢大面积软组织缺损

Free Musculocutaneous Flap for Large Soft-tissue Defects in the Lower Limbs

目的:探讨下肢软组织缺损的修复。方法:受区彻底清创,并解剖出拟吻合的胫前或胫后血管。合并骨折者先安装外固定架,再依软组织缺损面积切取背阔肌皮瓣或腹直肌皮瓣。皮瓣移至受区,胸背血管或腹壁下血管与胫前或胫后血管吻合。结果:应用该方法共修复29例,21例采用腹直肌皮瓣,8倒背阔肌皮瓣。皮瓣全部成活。结论:胸背皮瓣和背阔肌皮瓣血管蒂恒定,可切取面积大,是修复下肢软组织缺损的较好皮瓣。

To provide a restoring way of soft-tissue defect in the lower extremities. Methods: To dissect the anterior or posterior tibial vessels for use after debridement of recipient wound. Depending on the size of soft-tissue defect of recipient wound, the muscular latissimus dorsi or rectus abdominis flap was harvested after installing external fixator for fracture. Thoraco-dorsal vessels or inferior epigastric vessels was anastomosed with the anterior or posterior tibial vessels after the flap was transferred to the recipient site. Results: 29 patients were treated with this method. Among them, 21 cases by rectus abdominis flap while 8 by muscular latissimus dorsi flap. All were uneventful postoperatively. Conclusion: The muscular latissimus dorsi or rectus abdominis flap might be a better choice for a large soft-tissue defect in the lower limbs because of its constant vascular pedicle and large skin paddle.