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阔筋膜张肌穿支皮瓣:当没有足够大的皮肤穿支时,作为股前外侧皮瓣的一种替代重建选择。

Tensor fascia latae perforator flap: An alternative reconstructive choice for anterolateral thigh flap when no sizable skin perforator is available.

作者信息

Contedini Federico, Negosanti Luca, Pinto Valentina, Tavaniello Beatrice, Fabbri Erich, Sgarzani Rossella, Tassone Daniela, Cipriani Riccardo

机构信息

Department of Plastic Surgery, S. Orsola-Malpighi University Hospital, Bologna, Italy.

出版信息

Indian J Plast Surg. 2013 Jan;46(1):55-8. doi: 10.4103/0970-0358.113707.

Abstract

INTRODUCTION

The anterolateral thigh flap (ALT) is a versatile flap and very useful for the reconstruction of different anatomical districts. The main disadvantage of this flap is the anatomical variability in number and location of perforators. In general, absence of perforators is extremely rare. In literature, it is reported to be from 0.89% to 5.4%. If no sizable perforators are found, an alternative reconstructive strategy must be considered. Tensor fascia lata (TFL) perforator flap can be a good alternative in these cases: Perforator vessels are always present, the anatomy is more constant and it is possible to harvest it through the same surgical access. The skin island of the flap can be very large and can be thinned removing a large part of the muscle allowing its use for almost the same indications of the ALT flap.

MATERIALS AND METHODS

We report 11 cases of reconstruction firstly planned with the ALT flap, then converted into TFL perforator flap.

RESULTS AND CONCLUSION

The result was always satisfactory in terms of the donor site morbidity and reconstructive outcome.

摘要

引言

股前外侧皮瓣(ALT)是一种多功能皮瓣,对不同解剖区域的重建非常有用。该皮瓣的主要缺点是穿支血管的数量和位置存在解剖变异。一般来说,无穿支血管的情况极为罕见。据文献报道,其发生率为0.89%至5.4%。如果未发现足够大的穿支血管,则必须考虑替代的重建策略。在这些情况下,阔筋膜张肌(TFL)穿支皮瓣可能是一个很好的选择:穿支血管总是存在,解剖结构更恒定,并且可以通过相同的手术入路进行切取。皮瓣的皮岛可以非常大,并且可以通过去除大部分肌肉进行变薄处理,从而使其可用于几乎与ALT皮瓣相同的适应证。

材料与方法

我们报告了11例最初计划采用ALT皮瓣进行重建,随后改为TFL穿支皮瓣的病例。

结果与结论

就供区并发症和重建效果而言,结果始终令人满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e50f/3745122/e36e865bf799/IJPS-46-55-g001.jpg

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