Li Xiucun, Cui Jianli, Maharjan Suraj, Jiang Ziping, Lu Laijin, Gong Xu
From the Department of Hand and Foot Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, P.R. China.
Ann Plast Surg. 2017 May;78(5):526-532. doi: 10.1097/SAP.0000000000000920.
The posterior thigh region has been neglected as a donor site for free perforator flaps, likely due to difficulties in positioning the patient during surgery. This study describes the clinical application of the posterior thigh perforator flap based on the third perforating artery of the profunda femoris artery (PFA).
The free posterior thigh perforator flap based on the third perforating artery of the PFA was used for reconstruction of soft tissue defects in nine patients between February 2010 and May 2014.
Flap sizes ranged from 12 × 7 cm to 20 × 13 cm. The length of the vascular pedicle averaged 10.28 cm, and the mean diameters of the third perforating artery and venae comitantes were 1.68 and 1.14 mm, respectively. All of the perforators originated from the PFA. Of the 9 free flaps used in 9 patients, 7 flaps survived completely. There were no early complications in these flaps. During the follow-up period, no patient experienced cold intolerance, scar contracture, or scar pain. There were no functional impairments at the donor or recipient sites.
The posterior thigh flap based on the third perforating artery of the PFA is an excellent option for reconstructing soft tissue defects. The anatomical location of the third perforating artery is relatively consistent. The vascular pedicle is relatively longer and has large caliber vessels. The scar at the donor site can be well concealed with low morbidity. The skin color and texture of this flap show satisfactory results.
大腿后侧区域作为游离穿支皮瓣的供区一直被忽视，可能是由于手术中患者体位摆放困难。本研究描述了基于股深动脉（PFA）第三穿支动脉的大腿后侧穿支皮瓣的临床应用。
2010年2月至2014年5月期间，对9例患者采用基于PFA第三穿支动脉的游离大腿后侧穿支皮瓣修复软组织缺损。
皮瓣大小从12×7cm至20×13cm不等。血管蒂长度平均为10.28cm，第三穿支动脉和伴行静脉的平均直径分别为1.68mm和1.14mm。所有穿支均起源于PFA。9例患者使用的9个游离皮瓣中，7个皮瓣完全存活。这些皮瓣无早期并发症。随访期间，无患者出现耐寒能力下降、瘢痕挛缩或瘢痕疼痛。供区和受区均无功能障碍。
基于PFA第三穿支动脉的大腿后侧皮瓣是修复软组织缺损的极佳选择。第三穿支动脉的解剖位置相对恒定。血管蒂相对较长，血管口径较大。供区瘢痕可良好隐蔽，发病率低。该皮瓣的皮肤颜色和质地显示出令人满意的效果。
