Zhou Xiao, Wang Jin, Qiang Li, Rui Yongjun, Xue Mingyu
Department of Hand Surgery, Wuxi No. 9 People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, P.R. China.
Medicine (Baltimore). 2018 Apr;97(16):e0491. doi: 10.1097/MD.0000000000010491.
The anterolateral thigh (ALT) flap plays an essential part in plastic and reconstructive surgery. However, repair of the anterolateral donor site has not been the focus of the clinicians.To assess the clinical value and feasibility of using a modified anteromedial thigh (AMT) perforator flap for repairing the ALT free flap donor site.In this retrospective study, 16 ALT flaps were transferred to resurface large soft-tissue defects (ranged from 7 × 5 to 13 × 8 cm) in the foot or hand from June 2012 to March 2013. The donor sites were repaired with an advancement flap pedicled with an AMT perforator. Sensation within the advancement flap, return-to-work (RTW) time, the aesthetic appearance of the donor sites, and functional recovery were measured.All 15 flaps survived completely without necrosis. One flap developed partial necrosis in the tip but healed with dressing changes after 1 week. The medain follow-up period was 3.5 months (range, 3-6 months). The average median time was 9.5 weeks (range 8-13 weeks). There was no numbness of the advancement flap. Additionally, there was no specific complication at both the recipient and donor sites. Thigh quadriceps muscle strength and activities of the knee were normal. All patients were satisfied with the aesthetic outcome postoperatively at the 3-month to 6-month follow-up.The modified advancement flap pedicled with an AMT perforator is an ideal option for repairing the anterolateral donor site.
股前外侧(ALT)皮瓣在整形与重建外科中发挥着重要作用。然而,股前外侧供区的修复一直未受到临床医生的关注。评估采用改良股内侧(AMT)穿支皮瓣修复ALT游离皮瓣供区的临床价值和可行性。在这项回顾性研究中,2012年6月至2013年3月期间,16例ALT皮瓣被转移用于修复足部或手部大小为7×5至13×8厘米的大面积软组织缺损。供区采用以AMT穿支为蒂的推进皮瓣进行修复。测量推进皮瓣内的感觉、重返工作(RTW)时间、供区的美学外观以及功能恢复情况。所有15例皮瓣均完全存活,无坏死。1例皮瓣尖端出现部分坏死,但经换药1周后愈合。中位随访期为3.5个月(范围3至6个月)。平均中位时间为9.5周(范围8至13周)。推进皮瓣无麻木感。此外,受区和供区均未出现特定并发症。股四头肌力量及膝关节活动正常。所有患者在术后3至6个月的随访中对美学效果均满意。以AMT穿支为蒂的改良推进皮瓣是修复股前外侧供区的理想选择。