Yu Peirong, Selber Jesse, Liu Jun
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Ann Plast Surg. 2013 Jun;70(6):714-6. doi: 10.1097/SAP.0b013e318241446c.
When anterolateral thigh (ALT) perforators are inadequate, exploration of the contralateral thigh may be required. If anteromedial thigh (AMT) perforators were useable in these instances, harvest could proceed from a single donor site.
A prospective cohort study was performed examining 100 consecutive thighs. Anterolateral and anteromedial thigh skin territories were surgically explored, and perforator size and number were documented. The relationship between ALT and AMT size and number was examined using Fisher exact test, logistic regression, and linear regression.
Patients with small or no ALT perforators usually had a large AMT perforator. Patients with large or medium ALT perforators usually had medium or small AMT perforators (P = 0.029). Patients with small or no ALT perforators had a 6-fold increased chance of large/medium AMT perforators (odds ratio, 6.18; 95% confidence interval [CI], 1.23-30.91; P = 0.026). Patients without ALT perforators usually had 1 or more AMT perforators. Patients with 3 ALT perforators usually had no AMT perforators (P < 0.001). Patients with 1 or fewer ALT perforators had a 4-fold increased chance of an AMT perforator (odds ratio, 3.77; 95% CI, 1.34-10.65; P = 0.012). After assigning numeric values to perforators based on size, the total scores for ALT and AMT regions were analyzed using a linear regression model. Lower ALT perforator scores were significantly related to higher AMT scores (slope, -0.33; 95% CI, -0.46 to -0.20; P < 0.001). The Spearman test showed a similar relationship (ρ = -0.43, P < 0.001).
There is an inverse relationship between size and number of ALT and AMT perforators, that is, when ALT perforators are inadequate, AMT perforators are typically useable.
当大腿前外侧（ALT）穿支血管不足时，可能需要探查对侧大腿。如果在这些情况下大腿前内侧（AMT）穿支血管可用，则可以从单一供区进行取材。
进行了一项前瞻性队列研究，检查了连续的100条大腿。通过手术探查大腿前外侧和前内侧皮肤区域，并记录穿支血管的大小和数量。使用Fisher精确检验、逻辑回归和线性回归分析ALT和AMT大小及数量之间的关系。
ALT穿支血管小或无的患者通常有大的AMT穿支血管。ALT穿支血管大或中等的患者通常有中等或小的AMT穿支血管（P = 0.029）。ALT穿支血管小或无的患者有大/中等AMT穿支血管的几率增加6倍（比值比，6.18；95%置信区间[CI]，1.23 - 30.91；P = 0.026）。无ALT穿支血管的患者通常有1条或更多AMT穿支血管。有3条ALT穿支血管的患者通常无AMT穿支血管（P < 0.001）。ALT穿支血管为1条或更少的患者有AMT穿支血管的几率增加4倍（比值比，3.77；95% CI，1.34 - 10.65；P = 0.012）。根据大小为穿支血管赋值后，使用线性回归模型分析ALT和AMT区域的总分。较低的ALT穿支血管分数与较高的AMT分数显著相关（斜率，-0.33；95% CI，-0.46至-0.20；P < 0.001）。Spearman检验显示了类似的关系（ρ = -0.43，P < 0.001）。
ALT和AMT穿支血管的大小和数量之间存在负相关关系，即当ALT穿支血管不足时，AMT穿支血管通常可用。
