Moscatiello Fabrizio, Masià Jaume, Carrera Ana, Clavero José Antonio, Larrañaga José Ramòn, Pons Gemma
Plastic Surgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Sant Antoni M. Claret 167, 08025 Barcelona, Spain.
J Plast Reconstr Aesthet Surg. 2007;60(12):1323-30. doi: 10.1016/j.bjps.2007.02.027. Epub 2007 May 17.
The leg and peripatellar region have always been known as a poor source of available flaps. One flap donor site that has proven to be adequate is the distal anteromedial half of the thigh. Due to the potential and plentiful vascular sources of this anatomic region we decided to study the distal anteromedial thigh and its clinical applications. ANATOMIC STUDY: Sixteen cryopreserved inferior limbs were latex-injected in the femoral artery and the skin perforators of the distal anteromedial thigh and their source vessels were studied.
In a period between December 2000 and June 2005, skin islands from the distal anteromedial aspect of the thigh of six patients were transferred, as local perforator flaps, to reconstruct the peripatellar region and upper leg soft tissue defects. Every flap was based on a single adequate perforator vessel. The tissue was rotated, as a 'propeller', through 180 degrees and the flap was named 'the propeller distal anteromedial thigh perforator flap'.
In the distal anteromedial thigh the anatomic variability includes not only perforator vessels but also their source vessels. Skin perforators can come from each of the deep vessels. Our clinical results, with a follow up of 1-4 years, show no total flap losses. Partial necrosis > 20% happened in one diabetic patient.
The propeller distal anteromedial thigh perforator flap can be reliably transferred based on only one adequate perforator vessel. It reduces the morbidity and improves the availability of the distal anteromedial thigh as a flap donor site and represents an additional reconstructive option for knee and upper leg defects.
腿部及髌周区域一直被认为是皮瓣可用来源较少的部位。已被证明足够的一个皮瓣供区是大腿远端前内侧半区。鉴于该解剖区域潜在且丰富的血管来源，我们决定研究大腿远端前内侧区及其临床应用。
对16条冷冻保存的下肢进行股动脉乳胶注射，并研究大腿远端前内侧区的皮肤穿支及其源血管。
在2000年12月至2005年6月期间，将6例患者大腿远端前内侧的皮岛作为局部穿支皮瓣转移，用于重建髌周区域及大腿上段软组织缺损。每个皮瓣均基于一条合适的穿支血管。组织像“螺旋桨”一样旋转180度，该皮瓣被命名为“螺旋桨式大腿远端前内侧穿支皮瓣”。
在大腿远端前内侧，解剖变异不仅包括穿支血管，还包括其源血管。皮肤穿支可来自各条深部血管。我们的临床结果，随访1至4年，未出现皮瓣完全坏死情况。1例糖尿病患者出现了>20%的部分坏死。
螺旋桨式大腿远端前内侧穿支皮瓣仅基于一条合适的穿支血管即可可靠转移。它降低了供区并发症，提高了大腿远端前内侧作为皮瓣供区的可用性，为膝关节及大腿上段缺损提供了一种额外的重建选择。
