Sananpanich Kanit, Tu Yuan Kun, Kraisarin Jirachart, Chalidapong Preecha
Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Injury. 2008 Oct;39 Suppl 4:55-66. doi: 10.1016/j.injury.2008.08.032.
We report on 45 pedicle perforator flaps without harvesting major vessels in limb reconstruction. Of our patients, 25 had major vessel injury resulting from their initial injury. In the upper extremities, there were 13 posterior interosseous artery perforator flaps, four ulnar artery perforator flaps and three radial artery perforator flaps. In the lower extremities, there were 16 peroneal artery perforator flaps with an axis on the sural nerve, five peroneal artery perforator flaps with an axis on the superficial peroneal nerve and four posterior tibial artery perforator flaps with an axis on the saphenous nerve. There were 42 successes, one total flap loss, one epidermal necrolysis and one distal tip necrosis. Greater utilisation of pedicle perforator flaps probably will occur because they are technically simple to execute, violate only the involved extremity, do not sacrifice a major source vessel, bring similar local tissues into a defect, avoid prolonged immobilisation and do not require microsurgical expertise. The concept of the pedicle perforator flap can be applied to the same axis of a neurocutaneous flap, even in cases with injured cutaneous nerves.
我们报告了45例在肢体重建中未切取主要血管的带蒂穿支皮瓣。我们的患者中，25例因初始损伤导致主要血管损伤。在上肢，有13例骨间后动脉穿支皮瓣、4例尺动脉穿支皮瓣和3例桡动脉穿支皮瓣。在下肢，有16例腓动脉穿支皮瓣以腓肠神经为轴、5例腓动脉穿支皮瓣以腓浅神经为轴和4例胫后动脉穿支皮瓣以隐神经为轴。有42例成功，1例皮瓣完全坏死，1例表皮坏死松解，1例远端皮瓣尖端坏死。带蒂穿支皮瓣可能会得到更广泛的应用，因为它们技术操作简单，仅累及受伤肢体，不牺牲主要供血血管，将相似的局部组织带入缺损处，避免长时间固定，且不需要显微外科专业知识。带蒂穿支皮瓣的概念甚至可以应用于神经皮瓣的同一轴，即使在皮神经损伤的情况下。
