摘要
目的探讨保留多穿支的游离旋股外侧动脉穿支皮瓣在小儿四肢复杂性创面缺损的临床应用及经验。方法2016年1月至2017年1月,对收治的7例小儿四肢复杂软组织缺损患者采用保留多穿支的旋股外侧动脉穿支皮瓣进行修复。根据旋股外侧动脉穿支的体表投影及穿支分布特点,术前便携式Doppler穿支定位,对不需要重建韧带及关节囊者不携带阔筋膜，供区阔筋膜I期缝合。定期进行随访。结果本组7例皮瓣顺利成活，创面I期修复，皮瓣供区均直接缝合。经3~9个月随访（平均6.5个月，随访方式包括：现场随访、微信随访、电话随访等）。皮瓣色泽正常，质地良好。皮瓣供区仅留线性瘢痕，少数残留切口周围感觉异常。患肢外观、功能恢复满意。结论保留多穿支的旋股外侧动脉单叶或分叶穿支皮瓣设计灵活，穿支粗大恒定，是修复小儿四肢复杂软组织缺损的理想方法之一。
ObjectiveTo investigate the application of anterolateral thigh （ALT） free flap preserving multiple perforators descending from lateral circumflex femoral artery （LCFA） in reconstruction of complex defects of children extremities.MethodsFrom January, 2016 to January, 2017, 7 children admitted with soft tissue defects were reconstructed with ALT free flap preserving multiple perforitors descending from LCFA. According to body surface projection and distribution patterns of perforators descending from LCFA, preoperative portable Doppler was used to localize these perforators. Fascia lata harvest was spared for those without ligament and articular joint reconstruction. Defects and fascia lata was closed primarily. All patients were followed up at regular intervals.ResultsFollow-up period was 3-9 months （mean, 6.5 months. Follow-up methods include on-site follow-up, wechat follow-up, telephone follow-up, etc.） . The color of ALT flaps was normal. The texture of ALT flap was good. The linear scar in donor sites was found. The paresthesia around incision in donor sites was complained of. Postoperative appearance and function of injured limbs was satisfactory.ConclusionDesign of Unipaddled or multipaddled ALT free flap with multiple perforators descending from LCFA is flexible. Perforators are thick and consistent. ALT flap with multiple perforators descending from LCFA is an ideal one to be used in reconstruction of complex soft tissue defects.
出处
《中华显微外科杂志》
CSCD
北大核心
2017年第5期428-432,共5页
Chinese Journal of Microsurgery
基金
国家临床重点专科项目【国卫办医函[2013]544号】
贵州省优秀青年科技人才培养对象专项基金【黔科合人字（2013）12号】
关键词
股前外侧皮瓣
穿支皮瓣
旋股外侧动脉
儿童
四肢
显微外科手术
ALT flap, perforator flap
Lateral circumflex femoral artery
Children
Extremity
Microsurgical operation
