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股前外侧皮瓣在112例患者中的临床应用

[Clinical application of the anterolateral thigh flap in 112 patients].

作者信息

Zhang Qixu, Qiao Qun, Chen Guangyu

机构信息

Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100041, P.R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006 May;20(5):540-3.

Abstract

OBJECTIVE

To investigate the anatomic variations of the perforator vessels of anterolateral thigh (ALT) flap and the clinical indications.

METHODS

From March 1985 to August 2004, the anterolateral thigh flap graft was performed in 112 patients. The clinical data were analyzed. There were 67 males and 45 females, aging from 5 to 65 years with an average of 38. 5 years. According to recipient site condition, four methods of flap harvesting were as follows: (1) 78 received free fasciocutaneous flaps; (2) 22 received free adipofascial flaps; (3) 5 received pedicled island fasciocutaneous flaps; (4) 7 received pedicled reverse-flow island fasciocutaneous flaps. Facial, neck, breast, extremity joint, plantar, and perineum defects were repaired and the effectiveness and donor site morbidity were evaluated.

RESULTS

The blood supply of ALT flap came from the descending branch or transverse branch of the lateral circumflex femoral artery. The skin vessels were found to be septocutaneous perforators in 33% of flaps and to be musculocutaneous perforators in 77% of flaps. Of 112 flaps, 107 survived completely, the survival rate was 95.6% with little donor site morbidity.

CONCLUSION

ALT flap is a versatile soft-tissue flap. If refined to perforator flap, it can achieve better results in reconstructing defect and minimizing donor-site morbidity.

摘要

目的

探讨股前外侧(ALT)皮瓣穿支血管的解剖变异及临床适应证。

方法

1985年3月至2004年8月,对112例患者行股前外侧皮瓣移植术。分析临床资料。其中男67例,女45例,年龄5~65岁,平均38.5岁。根据受区情况,皮瓣切取方法如下:(1)78例采用游离筋膜皮瓣;(2)22例采用游离脂肪筋膜皮瓣;(3)5例采用带蒂岛状筋膜皮瓣;(4)7例采用带蒂逆行岛状筋膜皮瓣。修复面部、颈部、乳房、四肢关节、足底及会阴部缺损,评估其疗效及供区并发症。

结果

ALT皮瓣血供来自旋股外侧动脉降支或横支。发现33%的皮瓣皮肤血管为肌间隔穿支,77%的皮瓣皮肤血管为肌皮穿支。112例皮瓣中,107例完全成活,成活率为95.6%,供区并发症少。

结论

ALT皮瓣是一种多功能软组织皮瓣。若改良为穿支皮瓣,在修复缺损及减少供区并发症方面可取得更好效果。

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