Bota Olimpiu, Spindler Nick, Sauber Jeannine, Aydogan Emrah, Langer Stefan
Department for Plastic, Aesthetic and special Handsurgery, University Clinic Leipzig, Germany.
Plast Reconstr Surg Glob Open. 2017 Aug 28;5(8):e1372. doi: 10.1097/GOX.0000000000001372. eCollection 2017 Aug.
Soft-tissue defects caused by radiation injury are a challenging task for the reconstructive surgeon, due to the extent of the soft-tissue damage and the associated injuries of the local blood vessels and bone tissue. We present the application of the versatile deep inferior epigastric perforator (DIEP) flap for the coverage of an extended lateral thigh soft-tissue defect after the surgical resection of an undifferentiated pleomorphic high-grade sarcoma, neoadjuvant chemotherapy, and adjuvant chemo- and radiotherapy. A double-pedicled free DIEP flap (756 cm) was harvested and anastomosed to the transverse branch of the lateral femoral circumflex artery and a lateral branch of the popliteal artery (P1). The flap survived completely without serious complications, and the patient was able to walk with crutches 3 months postoperatively. This is the first case report of a free bipedicled DIEP flap for the coverage of a thigh defect in a male patient.
由于软组织损伤的程度以及局部血管和骨组织的相关损伤，放射性损伤导致的软组织缺损对重建外科医生来说是一项具有挑战性的任务。我们展示了多功能腹壁下深动脉穿支（DIEP）皮瓣在未分化多形性高级别肉瘤手术切除、新辅助化疗以及辅助放化疗后，用于覆盖大腿外侧广泛软组织缺损的应用。切取了一个双蒂游离DIEP皮瓣（756平方厘米），并将其与旋股外侧动脉横支和腘动脉外侧支（P1）进行吻合。皮瓣完全存活，无严重并发症，患者术后3个月能够借助拐杖行走。这是首例关于游离双蒂DIEP皮瓣用于覆盖男性患者大腿缺损的病例报告。
