| 摘要: |
| ［摘要］ 目的 评估游离股前外侧皮瓣修复小腿大面积软组织合并主干血管缺损的疗效。方法 回顾性分析该院2013-08～2017-09收治的15例严重小腿软组织合并主干血管缺损患者的临床资料。所有患者均一期清创、骨折复位固定；1例不全断肢患者急诊行游离皮瓣移植并桥接血管以恢复血供；14例患者一期采用负压封闭引流技术（VSD）覆盖创面，二期移植股前外侧皮瓣桥接动、静脉并覆盖创面。皮瓣切取面积15 cm×10 cm～30 cm×12 cm。结果 患者全部获得随访；术后2例患者发生静脉栓塞，经及时探查后血管复通；1例因局部感染创面延迟愈合；末次随访时所有皮瓣及肢体血运良好，供区无严重并发症发生，患肢外观及功能恢复满意。结论 应用股前外侧皮瓣在覆盖小腿创面的同时能修复保留肢体的主干血管，可改善肢体外观，增加远端血供。 |
| 关键词: 股前外侧皮瓣 小腿损伤 动脉缺损 软组织缺损 |
| DOI：10.3969/j.issn.1674-3806.2018.12.17 |
| 分类号:R 658 |
| 基金项目: |
|
| Anterolateral thigh flap for reconstruction of large soft tissue defects accompanied with segmental main artery defects in lower legs |
|
WU Jian, LUO Xu-chao, ZOU Yong-gen, et al.
|
|
Department of Orthopedics, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China
|
| Abstract: |
| ［Abstract］ Objective To study the clinical eficacy of anterolateral thigh flaps for the reconstruction of large soft tissue defects accompanied with segmental main artery defects in lower extremities. Methods The clinical data of 15 patients suffering from large soft tissue defects accompanied with segmental main artery defects in lower extremities in our hospital during August 2013 and September 2017 were retrospectively analyzed. All of the patients received debridement and bone fixation among whom 1 case received incomplete amputation in emergency and her flaps were transferred to the bridge blood vessels to restore blood supply, and 14 cases received vacuum sealing drainage(VSD) combined with secondary reconstruction of soft tissue defects with free anterolateral thigh flaps which ranged from 15 cm×10 cm to 30 cm×12 cm. Results All the patients were followed up, and all of the flaps survived completely. Two cases developed venous thrombosis postoperatively, and the flaps survived after the exploration. The wound healing was delayed in one case because of wound infection. At the time of the latest follow-up, all of the flaps had good appearance and abundant blood supply, without severe complications in the donor sites. The appearance and function of the affected limbs recovered satisfactorily. Conclusion For the patients suffering from large soft tissue defects accompanied with segmental main artery defects in lower legs, anterolateral thigh flap reconstruction technique is an ideal method to cover the tissue defects and avoid sacrificing major vessels. |
| Key words: Anterolateral thigh flap Lower leg injuries Artery defects Soft tissue defect |
