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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Sun Fengkun,Wang Limin,Song Xinghua,et al.Clinical application value of color Doppler ultrasound in the repair of skin and soft tissue defects in the extremities using the anterolateral thigh perforator flap pedicled with the oblique branch of the lateral circumflex femoral artery[J].Chin J Burns Wounds,2026,42(1):1-10.DOI: 10.3760/cma.j.cn501225-20240623-00247.
Citation: Sun Fengkun,Wang Limin,Song Xinghua,et al.Clinical application value of color Doppler ultrasound in the repair of skin and soft tissue defects in the extremities using the anterolateral thigh perforator flap pedicled with the oblique branch of the lateral circumflex femoral artery[J].Chin J Burns Wounds,2026,42(1):1-10.DOI: 10.3760/cma.j.cn501225-20240623-00247.
shu

Clinical application value of color Doppler ultrasound in the repair of skin and soft tissue defects in the extremities using the anterolateral thigh perforator flaps pedicled with the oblique branch of the lateral circumflex femoral artery

doi: 10.3760/cma.j.cn501225-20240623-00247
  • 1.

    Department of Orthopedics and Traumatology, Dongying Traditional Chinese Medicine Hospital, Dongying 257000, China

  • 2.

    Department of Hand and Foot Microsurgical Orthopedics, Dongying Second People's Hospital, Dongying 257000, China

More Information
  • Corresponding author: Zhao Xudong, Email: zhaoxudong1.234@163.com
  • Received Date: 2024-06-23
    Available Online: 2025-12-31
    Abstract
  •   Objective  To investigate the clinical application value of color Doppler ultrasound in the repair of skin and soft tissue defects in the extremities using the anterolateral thigh perforator flaps (ALTPF) pedicled with the oblique branch of the lateral circumflex femoral artery.  Methods  This study was a retrospective cohort study. A total of 30 patients admitted to Dongying Traditional Chinese Medicine Hospital from March 2018 to November 2020 who met the inclusion criteria were selected as the control group. The patients underwent repair of skin and soft tissue defects in the extremities using the ALTPF which pedicled with the oblique branch of the lateral circumflex femoral artery and designed and harvested based on the surgeon's clinical experience. Another 30 patients admitted to the same hospital from December 2020 to May 2023 who met the inclusion criteria were selected as the ultrasound group. The patients underwent repair of skin and soft tissue defects in the extremities using the ALTPF pedicled with the oblique branch of the lateral circumflex femoral artery and designed and harvested according to preoperative color Doppler ultrasound results. Among the patients, there were 49 males and 11 females, aged 19-60 years. After debridement, the wound areas ranged from 6.0 cm×3.0 cm to 13.0 cm×11.0 cm, and the harvested areas of ALTPF ranged from 7.0 cm×4.0 cm to 18.0 cm×8.0 cm. The donor site wounds were directly sutured. For patients in the ultrasound group, the consistency between the classification of the oblique branches of the lateral circumflex femoral artery and the number of its perforating vessels determined by the preoperative color Doppler ultrasound examination and the intraoperative exploration results was analyzed; the diameters of the oblique branches of the lateral circumflex femoral artery at its origin, the diameters of the vessels at the perforation points of its perforating branches, as well as the length of the vascular pedicle were compared between the preoperative color Doppler ultrasound examination and the intraoperative exploration. For patients in the two groups, the blood supply status of the flaps on postoperative days 1, 3, 5, 7, and 14 was scored using a flap blood supply assessment scale; the duration of flap surgery, intraoperative blood loss, and length of hospital stay were recorded; the incidence of tension blisters and venous crisis in the flap recipient areas within one week after surgery and flap necrosis within two weeks after surgery were recorded, and the incidence of incision dehiscence in the flap donor areas within two weeks after surgery and abnormal scar hyperplasia, sensory abnormalities, and decreased motor function within one year after surgery were recorded. One year after surgery, the satisfaction of patients in the two groups with the treatment outcomes was evaluated using a Likert 5-point scale.  Results  For patients in the ultrasound group, the preoperative color Doppler ultrasound examination revealed that the oblique branch of the lateral circumflex femoral artery was type 1 in 17 cases, type 2 in 5 cases, type 3 in 3 cases, type 4 in 3 cases, and type 5 in 2 cases, which was completely consistent with the intraoperative exploration findings (with Kappa coefficient of 1.00, P<0.05). The number of perforating vessels of the oblique branch of the lateral circumflex femoral artery detected by the preoperative color Doppler ultrasound examination showed a high degree of consistency with the intraoperative exploration results (with Kappa coefficient of 0.80, P<0.05). There were no statistically significant differences in the diameters of the oblique branches of the lateral circumflex femoral artery at its origin, the diameters of the vessels at the perforation points of its perforating branches, as well as the length of the vascular pedicle between the preoperative color Doppler ultrasound examination and the intraoperative exploration (with t values of 0.60, 0.85, and 0.78, respectively, P>0.05). On postoperative days 1, 3, 5, 7, and 14, the scores of flap blood supply status in the ultrasound group of patients were significantly higher than those in the control group (with t values of 8.64, 10.41, 10.84, 8.99, and 6.37, respectively, P<0.05). The duration of flap surgery and length of hospital stay in the ultrasound group of patients were significantly shorter than those in the control group (with t values of 5.34 and 3.73, respectively, P<0.05), and the intraoperative blood loss was significantly less than that in the control group (t=18.37, P<0.05). The incidence of complications in the flap donor and recipient areas in the ultrasound group of patients at different time points after surgery was significantly lower than that in the control group (P<0.05). One year after surgery, the satisfaction rate of patients with the treatment outcomes in the ultrasound group was significantly higher than that in the control group (P<0.05).  Conclusions  The color Doppler ultrasound was used to clarify the classification and distribution of the oblique branch of the lateral circumflex femoral artery preoperatively. Based on this, the ALTPF pedicled with the oblique branch of the lateral circumflex femoral artery was designed and harvested to repair the skin and soft tissue defects in the extremities, which can significantly improve the postoperative flap blood supply, effectively shorten surgical duration and length of hospital stay, reduce intraoperative blood loss and the incidence of complications, and enhance patients' satisfaction with treatment outcomes.

     

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    • References(42)
  • [1]
    杨林,曹阳,程俊楠,等.以旋股外侧动脉斜支为蒂股前外侧皮瓣的穿支分布特点与临床应用[J].中华整形外科杂志,2023,39(5):463-471.DOI: 10.3760/cma.j.cn114453-20230213-00031.
    [2]
    董帅,王石,滕志成,等.吲哚菁绿血管造影联合彩色多普勒超声在股前外侧穿支皮瓣穿支定位中的临床应用效果[J].中华烧伤与创面修复杂志,2025,41(11):1091-1100.DOI: 10.3760/cma.j.cn501225-20240629-00254.
    [3]
    李雷,周正虎,鞠文,等.以膝降动脉为蒂的游离股前外侧穿支皮瓣修复小腿保肢术后创面的临床效果[J].中华烧伤与创面修复杂志,2023,39(5):450-455.DOI: 10.3760/cma.j.cn501225-20220725-00308.
    [4]
    邓如非,胡翔天,黄国能,等.同侧带蒂股前外侧嵌合穿支皮瓣修复腹股沟区深度放射性溃疡8例[J].中华显微外科杂志,2025,48(3):309-314.DOI: 10.3760/cma.j.cn441206-20240928-00217.
    [5]
    张航,刘亚平,唐林俊,等.旋股外侧动脉降支远端穿支接力皮瓣修复股前外侧穿支皮瓣供区11例[J].中华显微外科杂志,2025,48(3):293-297.DOI: 10.3760/cma.j.cn441206-20250104-00002.
    [6]
    罗桦杰,王锦辉,余卓安,等.负压创面治疗技术辅助游离股前外侧穿支皮瓣修复四肢软组织缺损[J].中华显微外科杂志,2025,48(2):156-160.DOI: 10.3760/cma.j.cn441206-20240825-00194.
    [7]
    石攀成,周树萍,李士民,等.游离股前外侧穿支皮瓣修复肢体大面积Ⅳ度烧伤创面9例[J].中华显微外科杂志,2025,48(5):511-516.DOI: 10.3760/cma.j.cn441206-20250417-00089.
    [8]
    赵海磊,孙志刚,赵晓慧,等.股前外侧穿支皮瓣游离移植联合骨搬运序贯治疗小腿大面积皮肤软组织损伤伴大段胫骨缺损的临床效果[J].中华烧伤与创面修复杂志,2025,41(3):242-250.DOI: 10.3760/cma.j.cn501225-20240926-00350.
    [9]
    WongCH,WeiFC,FuB,et al.Alternative vascular pedicle of the anterolateral thigh flap: the oblique branch of the lateral circumflex femoral artery[J].Plast Reconstr Surg,2009,123(2):571-577.DOI: 10.1097/PRS.0b013e318195658f.
    [10]
    葛成伟,蒋国栋,程俊楠,等.以旋股外侧动脉斜支为蒂并携带阔筋膜的股前外侧穿支皮瓣修复手足毁损性创面并重建功能的效果[J].中华烧伤与创面修复杂志,2024,40(9):842-848.DOI: 10.3760/cma.j.cn501225-20240508-00163.
    [11]
    柳志锦,巨积辉,程俊楠,等.以旋股外侧动脉斜支为源动脉的股前外侧双叶穿支皮瓣修复四肢创面[J].中华显微外科杂志,2021,44(2):152-156.DOI: 10.3760/cma.j.cn441206-20210111-00012.
    [12]
    胡雨璇,姚凌峰,蒋燕,等.三维超声技术在老年患者股前外侧穿支皮瓣移植术前穿支动脉评估中的应用[J].国际老年医学杂志,2025,46(4):435-439.DOI: 10.3969/j.issn.1674-7593.2025.04.010.
    [13]
    董凯旋,周娅,连星烨,等.股前外侧穿支皮瓣和小腿穿支螺旋桨皮瓣修复足踝部软组织缺损的对比研究[J].中华显微外科杂志,2025,48(2):135-141.DOI: 10.3760/cma.j.cn441206-20240710-00171.
    [14]
    杨富强,赵玉祥,高学建,等.基于彩色多普勒超声的双叶股前外侧穿支皮瓣分型及供区评估研究[J].中华创伤骨科杂志,2025,27(6):521-528.DOI: 10.3760/cma.j.cn115530-20240811-00337.
    [15]
    郑民华,李树春,赵轩. 科技创新驱动微创外科的发展[J]. 中华消化外科杂志,2023,22(04):449-454.DOI: 10.3760/cma.j.cn115610-20230324-00128.
    [16]
    李雪齐,程广文,乔晓慧,等.多参数超声定量评估高风险脂肪性肝炎的临床价值[J].中华肝脏病杂志,2024,32(9):820-827.DOI: 10.3760/cma.j.cn501113-20240320-00146.
    [17]
    胡浩良,陈宏,李苗钟,等. CT血管造影辅助下以旋股外侧动脉斜支血管为蒂的游离股前外侧穿支皮瓣修复四肢软组织缺损[J]. 中华创伤杂志,2021,37(9):780-785. DOI: 10.3760/cma.j.cn501098-20210126-00072.
    [18]
    周飞亚,张弦,蔡乐益,等.精准定位的微型股前外侧穿支皮瓣修复手指中等面积皮肤软组织缺损的效果[J].中华烧伤与创面修复杂志,2024,40(2):165-171.DOI: 10.3760/cma.j.cn501225-20231030-00150.
    [19]
    胡涛涛,常树森,魏在荣,等.改良三纵五横法在股前外侧穿支皮瓣修复术前穿支定位中的应用研究[J].中国修复重建外科杂志,2021,35(8):1027-1032.DOI: 10.7507/1002-1892.202103074.
    [20]
    张宏,王军,范向达,等.游离股前外侧穿支皮瓣修复头颈颌面部恶性肿瘤切除术后缺损的临床疗效分析[J].中国医学文摘(耳鼻咽喉科学),2022,37(5):52-57,封2.DOI: 10.19617/j.issn1001-1307.2022.05.52.
    [21]
    龚飞宇,魏在荣,金文虎,等.旋股外侧动脉斜支穿支皮瓣供区闭合方式探讨[J].中国美容整形外科杂志,2017,28(4):218-221.DOI: 10.3969/j.issn.1673-7040.2017.04.009.
    [22]
    万绍乐,沈永辉,蔡森,等.股前外侧穿支皮瓣与胸腹带蒂皮瓣修复手外伤软组织缺损的应用效果比较[J].中国医刊,2025,60(4):460-463.DOI: 10.3969/j.issn.1008-1070.2025.04.021.
    [23]
    丁桂友,李文涛,唐阳平,等.游离股前外侧分叶穿支皮瓣修复四肢复杂创面[J].临床骨科杂志,2024,27(5):625.DOI: 10.3969/j.issn.1008-0287.2024.05.006.
    [24]
    观小芳,王波,李鑫,等.3D打印辅助股前外侧穿支皮瓣修复术治疗踝关节周围复杂软组织缺损的疗效及安全性[J].中华医学美学美容杂志,2025,31(4):348-354.DOI: 10.3760/cma.j.cn114657-20241023-00147.
    [25]
    张舒曼,王佳,杜思铭.足底内侧岛状皮瓣与游离股前外侧穿支皮瓣在足跟部软组织缺损修复中的对比研究[J].空军航空医学,2025,42(3):225-228.DOI: 10.3969/j.issn.2097-1753.2025.03.008.
    [26]
    蓝波,傅尚俊,刘涛,等.CTA三维重建技术在游离双叶股前外侧穿支皮瓣移植修复四肢创面中的效果[J].中华医学美学美容杂志,2025,31(2):148-154.DOI: 10.3760/cma.j.cn114657-20241206-00207.
    [27]
    马涛,孟飞,秦宏玖.端侧吻合非一级源血管的游离股前外侧穿支皮瓣修复四肢软组织缺损14例[J].中华显微外科杂志,2024,47(1):34-38.DOI: 10.3760/cma.j.cn441206-20230911-00033.
    [28]
    罗翔,杨克勤,韦平欧,等.增强现实技术导航辅助设计分叶股前外侧穿支皮瓣修复四肢软组织缺损8例[J].中华显微外科杂志,2024,47(1):28-33.DOI: 10.3760/cma.j.cn441206-20230927-00043.
    [29]
    江起庭,姚翔.同侧股动脉闭塞致股前外侧穿支皮瓣发生血管危象1例[J].中华解剖与临床杂志,2025,30(9):638-640.DOI: 10.3760/cma.j.cn101202-20241114-00337.
    [30]
    武雷,丁英状,郝敏如,等.两种下腹部组织瓣修复四肢大面积皮肤软组织缺损后患者的腹部功能与外形[J].中华烧伤与创面修复杂志,2023,39(10):959-967.DOI: 10.3760/cma.j.cn501225-20230428-00145.
    [31]
    SteinA,AtlanM,HervochonR,et al.Reconstruction by thoracodorsal perforator flap after petrosectomy[J].Ann Chir Plast Esthet,2021,66(1):100-105.DOI: 10.1016/j.anplas.2020.04.003.
    [32]
    KimataY,UchiyamaK,EbiharaS,et al.Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases[J].Plast Reconstr Surg,1998,102(5):1517-1523.DOI: 10.1097/00006534-199810000-00026.
    [33]
    ShiehSJ,ChiuHY,YuJC,et al.Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation[J].Plast Reconstr Surg,2000,105(7):2349-2357; discussion 2358-2360.DOI: 10.1097/00006534-200006000-00006.
    [34]
    周耀,唐林峰,杨林,等.以旋股外侧动脉斜支和降支为蒂的股前外侧穿支皮瓣修复四肢创面效果的对比[J].中华显微外科杂志,2025,48(4):373-381.DOI: 10.3760/cma.j.cn441206-20241119-00251.
    [35]
    唐举玉,孙念哲,吴攀峰,等.股前外侧穿支皮瓣的个性化精准设计:十年1079例临床疗效分析[J].中国临床解剖学杂志,2024,42(5):510-516.DOI: 10.13418/j.issn.1001-165x.2024.5.04.
    [36]
    程俊楠,柳志锦,杨林,等.基于解剖学研究的三级命名法在旋股外侧动脉主要分支命名中的应用探讨[J].中华解剖与临床杂志,2022,27(1):13-18.DOI: 10.3760/cma.j.cn101202-20210410-00093.
    [37]
    邓呈亮,肖顺娥,魏在荣.旋股外侧动脉斜支作为股前外侧游离皮瓣优选血管蒂的可行性研究[J].中华烧伤杂志,2020,36(7):636.DOI: 10.3760/cma.j.cn501120-20190428-00217.
    [38]
    KimJH, YooH, EunS. Reconstruction of extensive soft tissue defects of lower extremity with the extended anterolateral thigh flap[J]. Int J Low Extrem Wounds, 2022,21(4):601-608. DOI: 10.1177/1534734620982238.
    [39]
    刘族安,黄志锋,马亮华,等.股前外侧皮瓣斜支血管的认识及斜支“陷阱”的处理[J].中华显微外科杂志,2021,44(2):146-151.DOI: 10.3760/cma.j.cn441206-20200724-00299.
    [40]
    ZeidermanMR,PuLLQ.Contemporary approach to soft-tissue reconstruction of the lower extremity after trauma[J/OL].Burns Trauma,2021,9:tkab024[2025-12-11].https://pubmed.ncbi.nlm.nih.gov/34345630/. DOI: 10.1093/burnst/tkab024.
    [41]
    DuQ,ZangM,ZhuS,et al.Improving the outcome of distally based anterolateral thigh flap reconstruction: New classification and surgical guidelines[J].J Plast Reconstr Aesthet Surg,2023,87:229-237.DOI: 10.1016/j.bjps.2023.10.062.
    [42]
    JiaoX,CuiC,NgSK,et al.The modified bilobed flap for reconstructing sacral decubitus ulcers[J/OL].Burns Trauma,2020,8:tkaa012[2025-12-11]. https://pubmed.ncbi.nlm.nih.gov/33335930/. DOI: 10.1093/burnst/tkaa012.
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