Tao Li, Zhenbing Chen, Yanhua Chen, Xiaobin Cong, Fangxing Ai, Kun Wang, Guangxiang Hong
Zhonghua Zheng Xing Wai Ke Za Zhi. 2014 Sep;30(5):339-43.
To investigate the clinical application of flow-through deep inferior epigastric perforator flaps for reconstruction of large defects at the extremities.
The deep inferior and superior epigastric arteries were designed as the axial vessel and the arterial supply to the flap was the paraumbilical perforator artery. Free deep inferior epigastric perforator flaps were harvested in flow- through manners to reconstruct associated arterial defect in the wound. The sensation assessment,Enneking score,and questionnaire of the flap aesthetic were all performed during follow-up period.
From December 2011 to September 2012, 5 patients with large defects at extremities were treated. The deep inferior and superior epigastric arteries were designed as the axial vessel and the arterial supply to the flap was the paraumbilical perforator artery. The wound defects ranged form 11 cm x 5 cm to 30 cm x 11 cm. And the flap size ranged from 13 cm x7 cm to 33 cm x 13 cm. All flaps survived completely. The recipient arteries were all bypassed well documented by color Doppler examinations. All cases had 12-24 months' follow-up period. The flaps had good appearance and high aesthetic satisfactory(100%). 12 months after operations, sensation assessment were all S3+, and the Enneking score ratios were 82%-95% ,with 87.2% in average.
Flow-through deep inferior epigastric perforator flaps are reliable and effective for reconstruction of large defects at the extremities with maintenance of the vascular status of the extremities. The flaps can also be designed in transverse or oblique mode for clinical application.
探讨穿支型腹壁下深动脉皮瓣在四肢大面积缺损修复中的临床应用。
以腹壁下深动脉和腹壁上动脉为轴型血管，皮瓣血供为脐旁穿支动脉。采用穿支型切取游离腹壁下深动脉皮瓣修复创面相关动脉缺损。随访期间进行感觉评估、Enneking评分及皮瓣美学问卷调查。
2011年12月至2012年9月，共治疗5例四肢大面积缺损患者。以腹壁下深动脉和腹壁上动脉为轴型血管，皮瓣血供为脐旁穿支动脉。创面缺损范围为11 cm×5 cm至30 cm×11 cm，皮瓣大小为13 cm×7 cm至33 cm×13 cm。所有皮瓣均完全成活。彩色多普勒检查证实受区动脉均吻合良好。所有病例随访12 - 24个月。皮瓣外观良好，美学满意度高（100%）。术后12个月感觉评估均为S3 +，Enneking评分优良率为82% - 9%"，平均为87.2%。
穿支型腹壁下深动脉皮瓣修复四肢大面积缺损可靠有效，能维持肢体血运。皮瓣还可设计为横行或斜行应用于临床。
