Li Zhihua, Li Pandeng, Tan Qian
Department of Burn and Plastic Surgery.
Ann Plast Surg. 2018 Oct;81(4):462-467. doi: 10.1097/SAP.0000000000001544.
To study the availability and effects for application of 4 kinds of perforator flaps in repairing skin and soft tissue defects in different positions around the knee joints.
The present study included 26 cases (16 males and 10 females) with soft tissue defects with ages from 7 to 82 years who came to our hospital during September 2012 to August 2016. The wound size ranged from 6 × 3 cm to 15 × 12 cm, and the exposed area ranged from 4 × 2 cm to 10 × 8 cm. Patients were treated with different perforator flaps (descending genicular artery perforator flap, sural neurocutaneous flap, lateral superior genicular artery perforator flap, and lateral popliteal artery perforator flap) and were followed up for 6 months.
All the transplanted flaps survived well without advent events. Exposed bone, ligament, and skin and soft tissue defects healed well. In the early period, flaps were locally bloated. In the later period, the appearance of flaps was good and close to normal, with abrasion-resistant surfaces. All patients were satisfied with the flap appearance and functional recovery. No secondary necrosis, ulcers, deep infection, or nonunion of bone occurred during the follow-up.
These 4 kinds of perforator flaps are available methods to repair the skin and soft tissue defects around the knee joints. Suitable perforator flaps should be chosen for different locations of wounds.
Therapeutic study, level IV.
研究4种穿支皮瓣在修复膝关节周围不同部位皮肤软组织缺损中的应用可行性及效果。
本研究纳入2012年9月至2016年8月期间我院收治的26例软组织缺损患者（男16例，女10例），年龄7至82岁。创面大小为6×3 cm至15×12 cm，外露面积为4×2 cm至10×8 cm。患者采用不同的穿支皮瓣（膝降动脉穿支皮瓣、腓肠神经营养血管皮瓣、膝上外侧动脉穿支皮瓣、腘外侧动脉穿支皮瓣）进行治疗，并随访6个月。
所有移植皮瓣均顺利成活，无不良事件发生。外露骨质、韧带及皮肤软组织缺损均愈合良好。早期皮瓣局部肿胀，后期皮瓣外观良好，接近正常，表面耐磨。所有患者对皮瓣外观及功能恢复均满意。随访期间未发生继发性坏死、溃疡、深部感染或骨不连。
这4种穿支皮瓣是修复膝关节周围皮肤软组织缺损的可行方法。应根据创面不同部位选择合适的穿支皮瓣。
治疗性研究，四级。
