Madariaga J, Duboys E B, Stern J T
Department of Surgery, School of Medicine, State University of New York, Stony Brook 11794-8191.
J Surg Oncol. 1989 Jul;41(3):206-9. doi: 10.1002/jso.2930410315.
Myocutaneous coverage of large defects in the thigh following resection of tumors is necessary to ensure adequate protection of the underlying femoral vessels. The usual muscles employed as flaps to achieve this protection are ipsilateral sartorius, rectus femoris, tensor fasciae latae, gracilis, rectus abdominis, or vastus lateralis. However, for situations in which these muscles are not available, the surgeon needs an alternative flap. This report details the successful use of the contralateral rectus femoris muscle to cover exposed femoral vessels in the upper and middle thirds of the thigh. Findings of anatomical dissections confirm that, by freeing the muscle at its origin, its reach can be extended about 6 cm. Postoperatively, no functional deficits resulted from the flap and no damage to the skin graft occurred with radiation therapy. Use of the contralateral rectus femoris flap should therefore be considered when a reliable alternative to conventional flaps must be employed.
切除肿瘤后，大腿大缺损的肌皮覆盖对于确保充分保护股血管至关重要。通常用作皮瓣以实现这种保护的肌肉是同侧缝匠肌、股直肌、阔筋膜张肌、股薄肌、腹直肌或股外侧肌。然而，在这些肌肉不可用的情况下，外科医生需要一种替代皮瓣。本报告详细介绍了成功使用对侧股直肌覆盖大腿上中三分之一处暴露的股血管。解剖学研究结果证实，通过在其起点处松解肌肉，其延伸范围可扩大约6厘米。术后，皮瓣未导致功能缺陷，放疗也未对皮肤移植造成损害。因此，当必须采用可靠的传统皮瓣替代方案时，应考虑使用对侧股直肌皮瓣。
