Lin Pao-Yuan, Kuo Yur-Ren, Kueh Nai-Siong, Jeng Seng-Feng
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Kaohsiung, Taiwan.
J Reconstr Microsurg. 2003 Nov;19(8):537-41. doi: 10.1055/s-2004-815640.
Minimally invasive surgery without endoscopic assistance for gracilis muscle flap harvest is extensively used at the authors' institution. However, the proximal incision is still visible. The purpose of this study was to place the proximal incision in the groin area, to improve the cosmetic result at the donor site. In the reported series, nine male and three female patients were evaluated, with patient ages ranging from 31 to 75 years. Ten patients had lower extremity reconstruction, one had a forearm defect, and the other, a head and neck defect. The proximal incision was 5 to 6 cm in length in the groin area. The distal incision was 1.5 cm in length around the knee. After adequate exploration and dissection of the major pedicle of the gracilis muscle flap, which was located at 7 to 8 cm below the groin crease under direct vision, a standard long blunt dissector was used to separate the gracilis muscle. The average incision was about 7 cm in length, and the harvesting time was 55 min. All the free muscle transfers were successful and without major complications. The proximal incision was almost invisible after 3 months. Two patients developed partial loss of the skin graft, requiring further skin grafting. Compared with the conventional technique, this method proved to be advantageous in its easier performance, shorter incision, fewer morbidities, and better appearance at the donor site.
在作者所在机构，不借助内镜辅助进行股薄肌皮瓣切取的微创手术被广泛应用。然而，近端切口仍可见。本研究的目的是将近端切口置于腹股沟区，以改善供区的美观效果。在报道的系列病例中，评估了9名男性和3名女性患者，患者年龄在31至75岁之间。10例患者进行了下肢重建，1例有前臂缺损，另1例有头颈部缺损。近端切口位于腹股沟区，长度为5至6厘米。远端切口在膝关节周围，长度为1.5厘米。在直视下充分探查和解剖位于腹股沟皱襞下方7至8厘米处的股薄肌皮瓣主要蒂部后，使用标准的长钝头剥离器分离股薄肌。平均切口长度约为7厘米，切取时间为55分钟。所有游离肌转移均成功，无重大并发症。3个月后近端切口几乎不可见。2例患者出现植皮部分丢失，需要进一步植皮。与传统技术相比，该方法在操作更简便、切口更短、并发症更少以及供区外观更好方面被证明具有优势。
