摘要
目的探讨腓骨骨皮瓣与股前外侧皮瓣组合移植修复严重小腿软组织缺损并骨缺损的临床效果。方法应用腓骨骨皮瓣与股前外侧皮瓣串联或并联组合移植，修复严重小腿软组织缺损并骨缺损36例。新鲜无菌创面10例，晚期感染创面26例。创面面积25cm×18cm～45cm×13cm．平均36cm×16cm，股前外侧皮瓣切取范围12cm×13cm～32cm×18cm．腓骨骨皮瓣切取范围2．0cm×1．5cm～18．0cm×16．0cm，腓骨切取长度10～24cm。并联移植30例，串联移植6例，急诊手术5例，亚急诊手术5例，择期手术26例。结果36例全部成功，35例获得随访，随访时间1．3年。术后发生动脉危象1例，静脉危象2例。移植组织全部成活34例，2例并联腓骨皮瓣部分坏死，行皮片移植后愈合。修复创面一期愈合32例，二期愈合4例，愈合时间12～28d，腓骨移植骨愈合时间3～6个月。应用Enneking评分23—28分，平均26分，供区无功能障碍。结论腓骨骨皮瓣与股前外侧皮瓣组合移植修复小腿软组织缺损并骨缺损可使复杂创面修复一期完成，虽难度大风险高，但仍是一种理想的治疗方法。
Objective To explore the clinical application and effect of the transplantation of the cutaneous fibular flap combined with anterolateral thigh flap for the repair of complex tissue defect of the leg. Methods The cutaneous fibular flap combined with anterolateral thigh flap in series connection or parallel connection transfer were applied to repair complex tissue defect of the leg in 36 cases. 10 cases were fresh non-infectious wound 26 cases were delayed infectious wound. The area of wound ranged from 25 cm × 18 cm to 45 cm ×13 cm （36 cm× 16 cm on average）. The area of anterolateral thigh flap ranged from 12 cm × 13 cm to 32 cm ×18 cm. The area of the cutaneous fibular flap ranged from 2.0 cm ×1.5 cm to 18.0 cm×16.0 cm. The length of fibular transplantation ranged from 10 cm to 24 cm. 30 cases were combined in parallel connection transfer, 6 cases were combined in series connection transfer, 5 cases were repaired in emergency, 5 cases were repaired in subemergency, 26 cases were repaired in delay. Results All cases were successfully repaired in 36 cases.35 cases were followed up. A mean follow- up was 29 months. Arterial crisis occurred in 1 case, venous crisis occurred in 2 cases 34 flaps survived completely and 2 cutaneous fibular flap survived partially in parallel connection which were later healed by skin transplantation.32 cases were healed in first stage, 4 cases were healed in second stage, （healing time ranged from 12 to 18 days）, Bone healing time ranged from 3 to 6 months in fibula transplantation. The Enneking score system was applied to evaluate the leg function. Of the 35 cases, the mean scores was 26 （their scores ranged from 23 to 28）.The functions of all supplied regions were not found malfunctional. Conclusion Transplantation of the cutaneous fibular flap combined with anterolateral thigh flap is an optimal method to repair the complex tissue defect of the leg.
出处
《中华显微外科杂志》
CSCD
北大核心
2009年第2期116-118,I0004,共4页
Chinese Journal of Microsurgery
关键词
腓骨皮瓣
股前外侧皮瓣
移植
显微外科
The cutaneous fibular flap
Anterolateral thigh flap
Transplantation
Microsurgery
