Clinical effects of free superficial femoral artery femoral triangle perforator flap in the repair of skin and soft tissue defects in extremities
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摘要: 目的 探讨游离股浅动脉股三角穿支皮瓣修复四肢皮肤软组织缺损的临床效果。 方法 2016年1月—2017年11月,笔者单位收治四肢皮肤软组织缺损伴肌腱、骨外露患者14例(男9例、女5例,年龄19~54岁)。清创后皮肤软组织缺损面积为7 cm×3 cm~10 cm×7 cm,采用游离股浅动脉股三角穿支皮瓣修复,皮瓣面积为13.0 cm×2.0 cm~20.0 cm×4.5 cm,切取皮瓣时带上股内侧皮神经。6例患者穿支皮瓣吻接了股内侧皮神经。供区均直接拉拢缝合。观察皮瓣成活及患者随访情况。 结果 本组14例患者皮瓣均成活,13例患者供受区创面愈合;1例患者皮瓣边缘部分表皮坏死,经处理后愈合。所有患者术后随访6个月~1年,皮瓣外形良好,色泽接近正常,质地柔软,未出现瘢痕挛缩畸形;6例吻接了股内侧皮神经患者皮瓣保护性感觉存在,其余8例患者皮瓣感觉恢复稍差;14例患者供区大腿外观及行走功能无明显影响,内侧仅遗留一线状瘢痕,供区无感觉麻木。 结论 游离股浅动脉股三角穿支皮瓣移植是修复四肢皮肤软组织缺损的一种较理想方法。
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关键词:
- 外科皮瓣 /
- 四肢 /
- 软组织损伤 /
- 股浅动脉股三角穿支皮瓣
Abstract: Objective To investigate the clinical effects of free superficial femoral artery femoral triangle perforator flap in the repair of skin and soft tissue defects in extremities. Methods From January 2016 to November 2017, 14 patients (9 males and 5 females, aged 19 to 54 years) with skin and soft tissue defects in extremities accompanied with tendon and bone exposure were admitted to our unit. The size of skin and soft tissue defects after debridement ranged from 7 cm×3 cm to 10 cm×7 cm. The defects were repaired with free superficial femoral artery femoral triangle perforator flaps, with size ranging from 13.0 cm×2.0 cm to 20.0 cm×4.5 cm. The medial femoral cutaneous nerve was applied to the flap. The perforator flap was grafted onto the medial femoral cutaneous nerve in 6 patients. The donor sites were sutured directly. The survival of flaps and the follow-up of patients were observed. Results All flaps of 14 patients survived successfully. The recipient sites and donor sites were healed completely in 13 patients, and 1 patient with partial skin necrosis at the edge of flap was healed after treatment. All patients were followed up for 6 months to 1 year after the operation. The flaps were in good shape, with nearly normal color and soft texture and no cicatrix contracture deformity. The flaps recovered protective sense in 6 patients who had medial femoral cutaneous nerve grafting, and the sensory recovery of the flap was slightly worse in the remaining 8 patients. There was no significant complications on the appearance and walking of the donor thigh in 14 patients, only a linear scar was left on the inner thigh, and no numbness was felt in the donor sites of patients. Conclusions The free superficial femoral artery femoral triangle perforator flap is an ideal therapy for repairing skin and soft tissue defects in extremities.
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