摘要
目的分析股前外侧皮瓣切取后供区损伤导致的并发症。方法1988年7月-2007年7月行股前外侧皮瓣修复术427例,其中33例术后出现供区并发症。其中男21例,女12例;年龄14～47岁,平均32.7岁。创面缺损范围16cm×7cm～28cm×13cm。术中股前外侧皮瓣切取范围16cm×7cm～30cm×13cm。供区直接缝合7例,中厚皮片游离植皮23例,逆行腹壁浅动脉皮瓣修复3例;供区植皮范围10cm×5cm～18cm×8cm。观察供区近期(<4周内)及远期(>6个月)的并发症发生情况。结果术后患者均获随访,随访时间8～54个月,平均21个月。26例(78.8%)出现近、远期供区并发症,7例(21.2%)仅出现远期并发症。近期并发症包括:植皮坏死23例(69.7%),伤口感染17例(51.5%),肌肉坏死2例(6.1%)。远期并发症包括:伤口迁延不愈21例(63.6%),严重瘢痕28例(84.8%),局部不适感25例(75.8%),股四头肌功能障碍16例(48.5%)。结论股前外侧皮瓣供区并发症发生与股前外侧区特殊的解剖结构,以及手术操作、患者身体状况有关。
Objective To investigate the donor-site complications of the anterolateral thigh flap and its influencing factors. Methods Between July 1988 and July 2007,427 patients were treated with anterolateral thigh flap. Among them,33 patients had postoperative donor-site complications and their clinical data were analyzed retrospectively. There were 21 males and 12 females aged 14-47 years old （average 32.7 years old）. The size of the wound defect ranged from 16 cm × 7 cm to 28 cm × 13 cm. The area of the flap harvested during operation ranged from 16 cm × 7 cm to 30 cm × 13 cm. The donor sites were treated by direct suture in 7 cases; free split-thickness skin graft in 23 cases,and reverse superficial epigastric artery flap repair in 3 cases. The size of graft in the donor site ranged from 10 cm × 5 cm to 18 cm × 8 cm. The occurrence of short-term （within 4 weeks） and long-term （over 6 months） complications were analyzed. Results All patients were followed up for 8-54 months （average 21 months）. There were 26 patients （78.8%） with short-term and long-term complications and 7 patients （21.2%） with long-term complications. The short-term complications included skin graft necrosis in 23 cases （69.7%）,wound infection in 17 cases （51.5%）,and muscle necrosis in 2 cases （6.1%）. The long-term complications included non-healing wounds in 21 cases （63.6%）,serious scar in 28 cases （84.8%）,discomfort in 25 cases （75.8%）,and dysfunction of the quadriceps femoris in 16 cases （48.5%）. Conclusion The occurrence of anterolateral thigh flap donor-site complications is related to the anatomical structure of the anterolateral thigh region,the surgical procedure,and the patient＇s physique.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2009年第10期1177-1179,共3页
Chinese Journal of Reparative and Reconstructive Surgery
基金
上海市科学技术委员会研究资助项目(074119650)~~
关键词
股前外侧皮瓣
供区
并发症
影响因素
Anterolateral thigh flap Donor site Complication Influencing factor
