摘要
目的探讨应用多种穿支皮瓣修复四肢皮肤软组织缺损的临床效果及手术要点。方法自1995年1月至2019年3月,采用胫后动脉穿支皮瓣、股前外侧穿支皮瓣、腹壁下动脉穿支皮瓣、胸背动脉穿支皮瓣等方法修复四肢皮肤软组织缺损256例。结果 256例患者中,一期成活205例;7例术后24 h内皮瓣出现少量散在的淡紫色淤点,局部应用抗血管痉挛药物治疗后顺利成活;43例发生血管危象,经手术探查后,36例成活,7例发生部分坏死,其坏死部分基底部已成活,最终行创面植皮修复;1例出现皮瓣边缘感染,经换药后逐渐愈合。术后随访6~36个月,移植皮瓣质地良好,外形较满意,受区肢体功能恢复良好。结论穿支皮瓣是修复四肢皮肤软组织缺损较理想的皮瓣。不同的穿支皮瓣有其各自的特点,应根据软组织缺损情况灵活选择,以达到受区外观良好及供区微创的目的。
Objective To explore the clinical efficacy and operation key points of multiple perforator flaps in the repair of the soft tissue defects in extremities. Methods From January 1995 to March 2019, 256 patients with soft tissue defects in extremities were repaired by posterior tibial artery perforator flap, anterolateral thigh perforator flap, deep inferior epigastric artery perforator flap and thoracodorsal artery perforator flap. Results In 256 patients, 205 patients healed in the first stage. A small amount of lilac petechiae occurred in 7 cases of flaps within 24 h after operation and survived after antispasmodic treatment. Vascular crisis occurred in 43 patients,36 flaps survived and 7 flaps suffered from partial necrosis after re-exploration. The base of necrotic part of the flaps survived and the skin grafting was finally performed in the wounds. Infection of the edge of flap was occurred in 1 patient and gradually healed after dressing change. All patients were followed-up from 6 to 36 months. The texture of transplanted flaps was good and the appearance was satisfactory. The functions of recipient extremities recovered well. Conclusion The perforator flap is an ideal method for the repair of soft tissue defects in extremities. Various perforator flaps have their own characteristics. It should be selected according to the condition of soft tissue defects so as to achieve good appearance of the recipient site and the minimal invasion of the donor site.
作者
仲霄鹏
姜凯
丁小珩
王正丹
张宏勋
刘育杰
焦鸿生
刘春雷
刘明明
任胜全
吴彩风
ZHONG Xiao-peng;JIANG Kai;DING Xiao-heng;WANG Zheng-dan;ZHANG Hong-xun;LIU Yu-jie;JIAO Hong-sheng;LIU Chun-lei;LIU Ming-ming;REN Sheng-quan;WU Cai-feng(Department of Hand Surgery,No.971 Hospital of PLA,Qingdao 266000,China)
出处
《中国美容整形外科杂志》
CAS
2020年第10期624-627,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
穿支皮瓣
软组织缺损
重建
修复
四肢
Perforator flap
Soft tissue defects
Reconstruction
Repair
Extremities
