组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (2): 141-.

• • 上一篇    下一篇

股前内侧穿支内增压技术在股前外侧穿支皮瓣修复大面积缺损中的应用

  

  • 出版日期:2023-04-01 发布日期:2023-05-09

The application of anterolateral thigh perforator flap with turbocharging technique of anteromedial thigh perforator in repairing large area defects

  • Online:2023-04-01 Published:2023-05-09

摘要:

目的 探讨股前内侧(Anteromedial thigh,AMT)穿支内增压技术在股前外侧(Anterolateral thigh,ALT)
穿支皮瓣修复大面积缺损中的临床应用和疗效。方法 回顾性分析 2014 年 3 月至 2021 年 12 月收治的 9 例四肢创
面患者的临床资料。其中,男性 6 例,女性 3 例,年龄 23~68 岁 ;创面缺损面积 20 cm×12 cm~25 cm×13 cm,皮
瓣面积与创面面积大致相等或略大。为增加 ALT 皮瓣存活率,使用较粗大的 AMT 穿支对旋股外侧动脉(Lateral
circumflex artery,LCFA)的远端或下行分支进行了血管增压术,并测量皮瓣宽度(Flap)和大腿周长(Thigh)的
比值(即 F/T 比值)。结果 延长的 ALT 内增压皮瓣完全存活,无皮瓣皮缘坏死,无严重并发症发生。所有患者 F/
T 比值平均 0.319(0.302~0.341),平均皮瓣宽度和大腿周长分别为 13.9 cm 和 43.6 cm。术后随访 6~16 个月(平均
10.2 个月),未见并发症发生。结论 AMT 穿支内增压技术在 ALT 穿支皮瓣切取面积过大时是较好的应急备选方案,
尤其是皮瓣宽度与大腿围比值大于 0.3 时,但该比值的可靠性尚需进一步研究证实。

关键词:

Abstract:

Objective To explore the application and clinical effects of anterolateral thigh (ALT) perforator flap with
turbocharging technique of anteromedial thigh perforator in repairing large area defects. Methods A retrospective case-series
study was conducted to analyze the clinical data of 9 patients with complex wounds of limbs from March 2014 to December
2021. There were 6 males and 3 females, aged 23-68 years. The defect area ranged from 20 cm×12 cm to 25 cm×13 cm. The
flap area was roughly equal or slightly larger than the wound area. Extended ALT perforator turbocharged flaps were done in 9
patients. An additional microvascular augmentation of the distal or descending branch of the lateral circumflex artery (LCFA)
with the sizable AMT perforator was performed during the operation to augment the viability of the ALT flap. The ratio of flap
width and thigh circumference was measured (F/T ratio). Results The extended ALT turbocharged flaps survived without
peripheral necrosis or serious complications. The average F/T ratio was 0.319 (0.302~0.341). The patients' average flaps width
and thigh circumference were 13.9 cm and 43.6 cm respectively. The mean follow-up was 10.2 months and no complications
were recorded. Conclusion ALT perforator flap with turbocharging technique of AMT perforator may be an alternative choice
when the flap area is too large, especially in patients whose F/T ratio is greater than 0.3. However, the reliability of this ratio still
needs further investigation.

Key words: