Han Hyun Ho, Choi Eun Jeong, Oh Deuk Young, Moon Suk Ho
Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, 222, Banpodaero, Seocho-gu, Seoul, 137-701, Republic of Korea.
Microsurgery. 2016 Oct;36(7):559-566. doi: 10.1002/micr.30042. Epub 2016 Mar 9.
A microsurgical pedicle-lengthening technique can be used when a pedicle length longer than that usually provided by an anterolateral thigh (ALT) flap is required. The purpose of this report is description of pedicle lengthening method from original pedicle length for free ALT flaps and presentation of the results of application of this technique in reconstruction from a series of cases.
The microsurgical pedicle-lengthening procedure was used in 10 patients who received free ALT flaps from January 2012 to June 2015. The location of reconstruction was the heel in 3 patients, foot in 3 patients, flank in 2 patients, forehead in 1 patient, and lower leg in 1 patient. The technique was categorized as two distinct 2 types according to the branching pattern of the perforator. The transected segments of the extra vessel lengths were translocated anterogradely, and used to perform pedicle extensions.
The average length of the original pedicle was 13.1 cm (range 10.1-16.4 cm), and the average gain in length using the pedicle-lengthening method was 6.5 cm (range 5.0-8.1 cm). All the flaps survived well postoperatively. Of the 10 patients, three experienced complications that included partial flap necrosis in one patient, wound dehiscence in one patient, and seroma in the third patient. No major complications occurred.
The microsurgical pedicle-lengthening technique described here offers a solution for pedicles that are shorter than expected, with additional surgery required. This method may help overcome emergency situations that can arise during ALT flap surgery. © 2016 Wiley Periodicals, Inc. Microsurgery 36:559-566, 2016.
当需要比股前外侧（ALT）皮瓣通常提供的蒂更长时，可采用显微外科蒂延长技术。本报告的目的是描述游离ALT皮瓣从原始蒂长度开始的蒂延长方法，并展示该技术在一系列病例重建中的应用结果。
2012年1月至2015年6月，10例接受游离ALT皮瓣的患者采用了显微外科蒂延长手术。重建部位为足跟3例，足部3例，侧腹2例，前额1例，小腿1例。根据穿支的分支模式，该技术分为两种不同类型。额外血管段的横断部分向前移位，用于进行蒂延长。
原始蒂的平均长度为13.1cm（范围10.1 - 16.4cm），采用蒂延长方法后的平均长度增加为6.5cm（范围5.0 - 8.1cm）。所有皮瓣术后均存活良好。10例患者中，3例出现并发症，包括1例部分皮瓣坏死，1例伤口裂开，第3例出现血清肿。未发生重大并发症。
本文所述的显微外科蒂延长技术为比预期短的蒂提供了一种解决方案，且无需额外手术。该方法可能有助于克服ALT皮瓣手术中可能出现的紧急情况。©2016威利期刊公司。显微外科36:559 - 566，2016。
