Hayashi A, Maruyama Y, Saze M, Okada E
Department of Plastic and Reconstructive Surgery, Toho University Sakura Hospital, 564-1 Shimoshizu, Sakura City, Chiba, 285-8741, Japan.
Br J Plast Surg. 2004 Oct;57(7):632-7. doi: 10.1016/j.bjps.2004.06.020.
An ulnar recurrent adipofascial flap was raised and turned over to reconstruct massive defects around the elbow and forearm after wide resection of malignant tumours. Compared to the fasciocutaneous flap, the ulnar recurrent adipofascial flap has the following advantages: (1) a larger flap can be harvested without the problem of primary closure of the donor site, (2) the contour and scar of the donor site is reasonably acceptable since no tension is presented, (3) the flap can be turned over to cover a wider area, and (4) debulking of the flap can be performed during the operation if needed. The rotation arc of the ulnar recurrent adipofascial flap reaches a wide region, including the distal one-half of the upper arm, the elbow, and the proximal two-thirds of the forearm. Sensory deficit in the forearm was avoided in our patients because meticulous separation and preservation of the medial cutaneous nerve of the forearm was achieved without jeopardising the blood supply to the flap. The ulnar recurrent adipofascial flap is an easy and reliable option for one-stage reconstruction of massive defects around the elbow.
掀起尺侧返行脂肪筋膜瓣并翻转，用于在广泛切除恶性肿瘤后重建肘部和前臂周围的大面积缺损。与筋膜皮瓣相比，尺侧返行脂肪筋膜瓣具有以下优点：（1）可以切取更大的皮瓣，且供区无需一期缝合；（2）由于不存在张力，供区的外形和瘢痕较易接受；（3）皮瓣可翻转以覆盖更广泛的区域；（4）如有需要，术中可对皮瓣进行减容。尺侧返行脂肪筋膜瓣的旋转弧可到达广泛区域，包括上臂远端的一半、肘部以及前臂近端的三分之二。在我们的患者中，通过仔细分离和保留前臂内侧皮神经，在不危及皮瓣血供的情况下避免了前臂感觉功能障碍。尺侧返行脂肪筋膜瓣是一期重建肘部周围大面积缺损的一种简便且可靠的选择。
