Wounds after recision in recurrence of dermatofibrosarcoma protuberan in the left shoulder and chest repaired with anteromedial thigh perforator flap instead of anterolateral thigh perforator flap: a case report
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摘要:
大理白族自治州人民医院烧伤整形外科于2017年10月23日收治1例左肩胸部隆凸性皮肤纤维肉瘤3次复发的52岁男性患者。手术完全切除皮肤隆凸性纤维肉瘤,创面缺损10 cm×10 cm,预计用右股前外侧穿支分叶皮瓣游离移植修复创面,但切取皮瓣时见股前外侧穿支部分缺如,仅见1条细小穿支,并且分离困难,遂放弃。通过相同的切口向内侧寻找股前内侧穿支血管,见1条粗大穿支,由独立的源动脉供血,血管蒂长度、口径与受区血管匹配。利用该穿支切取10 cm×10 cm的股前内侧穿支皮瓣修复缺损,供瓣区直接缝合。术后9个月随访,皮瓣颜色、质地、厚薄好,两点辨别觉距离30 mm,右大腿供瓣区遗留线状瘢痕。
Abstract:On October 23, 2017, a 52-year-old male patient with 3 recurrences of dermatofibrosarcoma protuberans in the left shoulder and chest was admitted to the Department of Burns and Plastic Surgery of Dali Bai Autonomous Prefecture People′s Hospital. Dermatofibrosarcoma protuberans on the skin were completely resected, leaving wound defect of 10 cm×10 cm. The wound was planned to be repaired by the transplantation of right anterolateral thigh perforator free flap. However, the anterolateral thigh perforator branch was absent during flap removal, and only one small perforating branch was found. Moreover, it was difficult to separate. Therefore, this flap cutting was given up. The anteromedial thigh perforator was explored through the same incision, and a thicker perforator was found, which was supplied by an independent iatrogenic artery. The length and diameter of the vascular pedicle matched with the blood vessels in the receiving site. An anteromedial thigh perforator flap (10 cm×10 cm) was cut to repair the defect. The postoperative 9-month follow-up revealed that the color, texture, and thickness of the flap were good, the two-point discrimination distance was 30 mm, and the linear scar remained at the donor site of right thigh.
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Key words:
- Surgical flaps /
- Dermatofibrosarcoma /
- Neoplasm recurrence, local
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