摘要
目的探讨采用顺行股前外侧带蒂皮瓣修复会阴部或腹股沟区创面的临床效果。方法该研究为回顾性观察性研究。2022年1月—2024年5月,福建医科大学附属协和医院收治7例符合入选标准的会阴部或腹股沟区创面患者,其中男5例、女2例,年龄54~72岁。清创后创面面积为8 cm×6 cm~16 cm×11 cm。术中切取面积为9 cm×7 cm~18 cm×13 cm的顺行股前外侧带蒂皮瓣修复创面。将皮瓣供区创面直接缝合或移植大腿刃厚皮片修复。术后观察皮瓣成活情况,皮瓣供区创面愈合及皮片成活情况。随访观察皮瓣质地、色泽、血运情况,根据Lovett肌力分级标准评估患侧下肢肌力,采用改良Ashworth量表评估患侧下肢肌张力,观察下肢运动恢复情况、创面有无复发和供区瘢痕形成情况。结果术后皮瓣均成活,皮瓣供区创面均愈合,皮片均成活。随访2~29个月,皮瓣质地柔软、色泽与周围正常皮肤组织相近、血运良好;患侧下肢肌力为4级者2例、5级者5例,肌张力均为0级,运动无异常;创面未复发,供区无明显瘢痕畸形。结论顺行股前外侧带蒂皮瓣移植是修复会阴部和腹股沟区创面的有效方式之一,手术操作简便,术后供受区外观较好,患肢功能良好,值得临床推广。
Objective To explore the clinical effects of antegrade anterolateral thigh pedicled flaps in repairing wounds in the perineum or inguinal regions.MethodsThe study was a retrospective observational study.From January 2022 to May 2024,7 patients with wounds in the perineum or inguinal regions who met the inclusion criteria were admitted to Fujian Medical University Union Hospital,including 5 males and 2 females,aged 54 to 72 years.The wound area after debridement was 8 cm×6 cm to 16 cm×11 cm.During the operation,antegrade anterolateral thigh pedicled flaps with area of 9 cm×7 cm to 18 cm×13 cm were harvested to repair the wounds.The wounds in the flap donor sites were sutured directly or repaired with split-thickness skin grafts from the thigh.The survival of flaps and the healing of wounds and the survival of skin grafts in flap donor sites were observed after operation.During follow-up,the texture,color,and blood supply of flaps were observed,the muscle strength of the lower extremities on the affected side was evaluated according to Lovett muscle strength grading standard,the muscle tension of the lower extremities on the affected side was evaluated by modified Ashworth scale,and the recovery of lower extremity movement,wound recurrence,and scar formation in the flap donor sites were observed.ResultsThe flaps all survived successfully after operation.All the wounds in the flap donor sites healed and the skin grafts all survived.During 2 to 29 months of follow-up,the flaps were soft in texture,similar in color to the surrounding normal skin tissue with good blood supply.The muscle strength of the lower extremities on the affected side was evaluated as grade 4 in 2 patients and grade 5 in 5 patients.The muscle tension was grade 0 in all patients with no abnormality in movement.No wound recurred and no obvious scar deformity in the flap donor site was observed.ConclusionsThe antegrade anterolateral thigh pedicled flap transplant is one of the effective methods to repair wounds in the perineum and inguinal regio
作者
王韶华
王顺宾
许钊荣
陈昭宏
Wang Shaohua;Wang Shunbin;Xu Zhaorong;Chen Zhaohong(Department of Burns and Wound Repair,Union Hospital,Fujian Medical University,Fujian Burn Institute,Fujian Burn Medical Center,Fujian Provincial Key Laboratory of Burn and Trauma,Fuzhou 350001,China)
出处
《中华烧伤与创面修复杂志》
CAS
CSCD
北大核心
2024年第10期978-984,共7页
Chinese Journal of Burns And Wounds
基金
福建省医疗“创双高”建设经费(闽卫医政〔2021〕76号)
福建省卫生计生青年科研课题资助计划(2017-1-44)。
