摘要
目的探讨以旋股外侧动脉降支外侧支为蒂的ALTPF的切取以及在创面修复中的应用。方法2019年1月-2021年3月,采用旋股外侧动脉降支外侧支为蒂的ALTPF修复四肢创面32例,其中男25例,女7例;年龄21~63岁,平均34岁;受伤机制:交通事故伤12例,机器绞伤8例,重物压砸伤6例,慢性感染性创面6例;软组织缺损面积8.2 cm×6.3 cm~18.6 cm×11.2 cm;供区直接拉拢缝合25例,游离植皮7例。所有需要皮瓣修复创面的患者术前常规行CTA及高频CDU检查,判断旋股外侧动脉降支外侧支大致走行方向及穿支血管位置。术后所有患者均行门诊规律性随访3~13个月,平均11个月。结果32例接受游离皮瓣手术进行修复的患者,术后无血管危象发生,皮瓣成活顺利,末次随访时,皮瓣外形美观无臃肿,供区无并发症发生。结论相较于传统ALTPF,股前外侧动脉降支外侧支穿支皮瓣切取相对简便,在一定程度上可替代传统ALTPF,值得在临床中推广应用。
Objective To investigate the removal of ALTPF pedicled with the lateral branch of the descending branch of the lateral femoral circumflex artery and its application in wound repair.Methods From January,2019 to March,2021,32 cases of limb wounds were repaired with ALTPF pedicled with the lateral branch of the descending branch of the lateral femoral circumflex artery,including 25 males and 7 females.The age ranged from 21 to 63 years,with an average of 34 years.Injury mechanism:there were 12 cases of traffic accident injury,8 cases of machine injury,6 cases of heavy object crushing injury and 6 cases of chronic infectious wound.The area of soft tissue defect was 8.2 cm×6.3 cm-18.6 cm×11.2 cm.There were 25 cases of direct suture and 7 cases of free skin grafting.All patients who needed flap repair underwent CTA and high-frequency CDU before operation to judge the approximate direction of the lateral branch of the descending branch of the lateral femoral circumflex artery and the position of the perforating branch.All patients were followed-up regularly for 3-13 months,with an average of 11 months.Results All patients who underwent free flap surgery had no vascular crisis and the flap survived smoothly.At the last follow-up,the appearance of the flap was beautiful without bloating and there were no complications in the donor area.Conclusion Compared with the traditional ALTPF,the perforator flap of the lateral branch of the descending branch of the anterolateral femoral artery is relatively simple,which can replace the traditional ALTPF to a certain extent,and is worthy of popularization and application in clinic.
作者
高增阳
刘超
佘立军
陈演志
段求兰
刘缄
雷彦文
张敬良
GAO Zengyang;LIU Chao;SHE Lijun;CHEN Yanzhi;DUAN Qiulan;LIU Jian;LEI Yanwen;ZHANG Jingliang(Department of Hand Surgery,Shunde Peace Surgical Hospital,Foshan,Guangdong Province 528308,China)
出处
《中华显微外科杂志》
CSCD
北大核心
2021年第5期512-516,共5页
Chinese Journal of Microsurgery
基金
佛山市卫生健康局医学科研课题(20210317)。
关键词
降支外侧支
旋股外侧动脉
股前外侧穿支皮瓣
四肢创面
修复
Lateral branch of descending branch,lateral femoral circumflex artery
Anterolateral thigh perforator flap
Limb wound
Repair