Jeong Hyung Hwa, Hong Joon Pio, Suh Hyun Suk
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Arch Plast Surg. 2018 Jul;45(4):304-313. doi: 10.5999/aps.2017.01529. Epub 2018 Jul 15.
Elevating thin flaps has long been a goal of reconstructive surgeons. Thin flaps have numerous advantages in reconstruction. In this study, we present a surgical method for elevating a thin flap and demonstrate the safety of the procedure. A retrospective review was performed of the electronic medical records of patients who underwent thin flap elevation for lower extremity reconstruction from April 2016 to September 2016 at the Department of Plastic Surgery of Asan Medical Center. All flaps included in this study were elevated above the superficial fascia. A total of 15 superficial circumflex iliac artery free flaps and 13 anterolateral thigh free flaps were enrolled in the study. The total complication rate was 17.56% (n=5), with total loss of the flap in one patient (3.57%) and partial necrosis of the flap in four patients (14.28%). No wound dehiscence or graft loss at the donor wound took place. Elevation above the superficial fascia is not inferior in terms of flap necrosis risk and is superior for reducing donor site morbidity. In addition to its safety, it yields good aesthetic results.
提升薄皮瓣长期以来一直是整形外科医生的目标。薄皮瓣在重建手术中有诸多优势。在本研究中,我们介绍了一种提升薄皮瓣的手术方法,并证明了该手术的安全性。对2016年4月至2016年9月在峨山医疗中心整形外科接受下肢重建薄皮瓣提升手术患者的电子病历进行了回顾性研究。本研究纳入的所有皮瓣均在浅筋膜上方进行提升。共纳入15例旋髂浅动脉游离皮瓣和13例股前外侧游离皮瓣。总并发症发生率为17.56%(n = 5),其中1例患者皮瓣完全坏死(3.57%),4例患者皮瓣部分坏死(14.28%)。供区伤口未发生伤口裂开或移植失败。在皮瓣坏死风险方面,在浅筋膜上方进行提升并不逊色,而且在减少供区并发症方面更具优势。除了安全性外,该方法还能产生良好的美学效果。