Deleyiannis Frederic W-B, Badeau Austin M, Leem Ted H, Song John I
Division of Plastic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, Colo.; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colo.; and University of Colorado School of Medicine, Aurora, Colo.
Plast Reconstr Surg Glob Open. 2014 May 7;2(4):e135. doi: 10.1097/GOX.0000000000000088. eCollection 2014 Apr.
This study introduces the options for supercharging and augmenting venous drainage of an anterolateral thigh free flap. Clinical indications and options for additional microvascular anastomoses are reviewed in 5 consecutive patients. The indications were simultaneous mucosal and cutaneous defects, divergent mucosal defects, and extensively wide and long cutaneous defects. Three additional vascular pedicles were anastomosed: the transverse branch of the lateral circumflex (n = 3), a perforator coming directly off the superficial femoral artery (n = 1), and a posterior perforator from the profundus femoral artery (n = 1). The anastomosis of a separate pedicle from the superior, medial, and/or posterior-lateral thigh may be a useful technique when confronted with an extensive defect that may not reliably be reconstructed with a routine anterolateral thigh flap based on a single perforator.
本研究介绍了股前外侧游离皮瓣增压及增加静脉引流的方法。对连续5例患者的临床适应证及额外微血管吻合的选择进行了回顾。适应证为同时存在黏膜和皮肤缺损、不同的黏膜缺损以及广泛且长宽的皮肤缺损。吻合了另外3支血管蒂：旋股外侧动脉横支（3例）、直接发自股浅动脉的穿支（1例）以及股深动脉的后穿支（1例）。当面对可能无法通过基于单一穿支的常规股前外侧皮瓣可靠重建的广泛缺损时，来自大腿上、内侧和/或后外侧的单独血管蒂吻合可能是一种有用的技术。
