摘要
目的探讨应用改良背阔肌皮瓣移植修复下肢巨大面积皮肤软组织缺损的可行性及临床效果。方法根据背阔肌皮瓣特点，切取有限面积的皮瓣携带大面积的背阔肌肌瓣，植皮区域由供区转移到受区。2009年4月至2011年8月共收治下肢巨大面积皮肤软组织缺损患者10例，皮肤软组织缺损范围19cm×10cm-32cm×16cm，均采用改良背阔肌皮瓣移植修复，受区肌瓣表面植皮修复，供区创面直接缝合。切取的背阔肌皮瓣加肌瓣面积最大33cm×17cm，最小20em×11am，其中皮瓣部分面积为20cm×6cm-33cmX10cm。结果术后所有皮瓣和植皮均顺利存活，无相关并发症。供区均直接缝合，愈合良好。术后随访6-36个月，皮瓣质地良好，外形不臃肿，供区仅留线性瘢痕，外观影响小，肩关节活动无影响。结论改良背阔肌皮瓣可用于修复下肢巨大面积皮肤软组织缺损，不但减少了供区并发症，还可改善供、受区的外形，值得临床推广应用。
Objective To explore the feasibility and clinic outcome of the modified latissimus dorsi flap when it is used to repair huge soft tissue defects in lower limbs. Methods The latissimus dorsi muscle is rich blood supply and available for harvest huge areas. According to these characteristics the modified latissimus dorsi flap was designed： a limited latissimus dorsi skin flap with a large area of latissimus dorsi muscle flap, skin graft area was transferred from donor-site to recipient-site. From April 2009 to August 2011, ten patients with large soft tissue defects in lower limbs were treated with modified latissimus dorsi flap. The size of skin and soft tissue defects range from 19 cm× 10 cm to 32 cm × 16 era. Ten modified latissimus dorsi flaps had been used for coverage of these wounds, which were amplified 1 - 2 cm compared with the corresponding wounds. The size of skin flap was 20 cm× 6 cm - 33 cm × 10 cm which was allowable to get direct closure of donor-site wounds. Results All the flaps and skin graft survived completely with no complication. Donor-site and recipient-site were primary closed and healing in all patients. All of the patients had got follow-up from 6 months to 36 months. All flaps survived with excellent color and quality, and no extremely fat contour. The results in donor site were satisfying and only left liner scar. It has no effect in the shoulder function. Conclusion The modified latissimus doris flap can provide with a huge amount of skin and soft tissue and be designed in various ways. It is a safe and reliable way to reconstruct huge skin and soft tissue defect in lower limbs.
出处
《中华显微外科杂志》
CSCD
北大核心
2013年第3期211-214,共4页
Chinese Journal of Microsurgery
关键词
背阔肌皮瓣
下肢
重建
显微外科
Latissimus doris flap
Lower extremety
Reconstruction
Microsurgery
