Yang Daping, Tang Maolin
Division of Plastic Surgery, 2nd Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang 150086, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Sep;25(9):1047-50.
To investigate the method and effectiveness of perforator flaps in repairing soft tissue defects of extremities.
Between June 2002 and December 2009, 81 patients with soft tissue defect of extremities were treated. There were 69 males and 12 females with an average age of 54 years (range, 13-75 years). Defect causes were injury in 35 cases (the disease duration ranged from 1 hour to 45 days), tumor resection in 19 cases, and scar resection in 27 cases. The defect located at limb and foot in 56 cases, forearm and hand in 25 cases. The defect size ranged from 3 cm x 3 cm to 23 cm x 18 cm. The perforator flaps included the peroneal artery perforator flap in 26 cases, the radial artery perforator flap in 18 cases, the medial plantar artery perforator flap in 18 cases, and the lateral circumflex femoral artery perforator flap in 19 cases. The flap size ranged from 4 cm x 3 cm to 25 cm x 18 cm. The donor site was sutured directly or repaired by free skin graft.
Partial necrosis of the flaps occurred in 4 cases at 3-7 days after operation, then the flap survived after expectant treatment. The other flaps and free skin grafts survived successfully, and the incisions healed by first intention. All patients were followed up 1 to 16 months with an average of 9 months. The appearance, texture, and colour of the flaps were similar to those of the donor site.
It is an effective method to use the perforator flap for repairing soft tissue defect of the extremities.
探讨穿支皮瓣修复四肢软组织缺损的方法及疗效。
2002年6月至2009年12月,收治81例四肢软组织缺损患者。其中男69例,女12例,平均年龄54岁(13 - 75岁)。缺损原因:外伤35例(病程1小时至45天),肿瘤切除19例,瘢痕切除27例。缺损位于肢体及足部56例,前臂及手部25例。缺损面积为3 cm×3 cm至23 cm×18 cm。穿支皮瓣包括腓动脉穿支皮瓣26例,桡动脉穿支皮瓣18例,足底内侧动脉穿支皮瓣18例,旋股外侧动脉穿支皮瓣19例。皮瓣面积为4 cm×3 cm至25 cm×18 cm。供区直接缝合或采用游离皮片修复。
术后3 - 7天有4例皮瓣出现部分坏死,经保守治疗后皮瓣成活。其余皮瓣及游离皮片均顺利成活,切口一期愈合。所有患者随访1至16个月,平均9个月。皮瓣外观、质地及颜色与供区相似。
应用穿支皮瓣修复四肢软组织缺损是一种有效的方法。