Miyamoto Shimpei, Kayano Shuji, Fujiki Masahide, Kamizono Kenichi, Fukunaga Yutaka, Sakuraba Minoru
From the *Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo; and†Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Ann Plast Surg. 2015 Feb;74(2):199-203. doi: 10.1097/SAP.0b013e3182996eaa.
Reconstructing large defects of the extremities is a challenging problem for reconstructive microsurgeons. The latissimus dorsi musculocutaneous flap (LDMCF) is widely used for this purpose, but a skin graft is needed when the defect is wider than available flaps. We used flow-through divided LDMCFs to reconstruct large defects of the extremities in 5 consecutive patients from 2010 through 2012. The semicircular skin island was split longitudinally, and 1 skin island was advanced over the other to close a round or oval defect without a skin graft. Postoperatively, all flaps survived completely, and the mean Enneking score was 90.0%. The flow-through divided LDMCF is a reliable and versatile option for reconstructing large defects of the extremities.
对于重建显微外科医生而言，修复四肢的大面积缺损是一个具有挑战性的问题。背阔肌肌皮瓣（LDMCF）广泛用于此目的，但当缺损宽度超过可用皮瓣时，则需要进行植皮。我们在2010年至2012年期间，连续对5例患者采用血流穿通型分割背阔肌肌皮瓣修复四肢大面积缺损。将半圆形皮岛纵向劈开，使一个皮岛覆盖在另一个皮岛上，从而在不进行植皮的情况下闭合圆形或椭圆形缺损。术后，所有皮瓣均完全存活，平均Enneking评分为90.0%。血流穿通型分割背阔肌肌皮瓣是修复四肢大面积缺损的一种可靠且通用的选择。
