Hui Taotao, Li Fengfeng, Wu Yongwei, Liu Jun, Ma Yunhong, Rui Yongjun
Department of Orthopedics and Trauma, the Wuxi Ninth Hospital Affiliated to Soochow University, Wuxi Jiangsu, 214062, P.R.China.
Department of Orthopedics and Trauma, the Wuxi Ninth Hospital Affiliated to Soochow University, Wuxi Jiangsu, 214062,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Dec 15;32(12):1572-1575. doi: 10.7507/1002-1892.201805042.
To explore the clinical application of vascular augmentation of an extra-long latissimus dorsi flap through an intercostal artery in limb wound repair.
Between January 2016 and December 2017, 5 patients with limb wounds were treated with the extra-long latissimus dorsi flaps. The vascular augmentation of the extra-long latissimus dorsi flap through the intercostal artery was applied during the operation. There were 4 males and 1 female, with an average age of 45.8 years (range, 43-59 years). The time from post-traumatic admission to flap repair was 7-25 days (mean, 12.3 days). The causes of injury included machine injury in 2 cases, traffic accident in 2 cases, and roller crush injury in 1 case. The wounds were located at the anterior of upper limb in 3 cases, the posterior of upper limb in 1 case, and the posterior of leg in 1 case. The size of wounds ranged from 26 cm×8 cm to 38 cm×10 cm. The size of the latissimus dorsi flap ranged from 36 cm×6 cm to 43 cm×7 cm. The size of the muscle flap ranged from 36 cm×10 cm to 43 cm×15 cm. The donor sites were closed directly.
The distal flap necrosis occurred in 1 case and healed after symptomatically treatment. The other flaps survived completely. The wounds and incisions at donor sites healed by first intention. All patients were followed up 8-18 months with an average of 14.9 months. At last follow-up, the flaps had satisfactory appearances, soft textures, and function of sweating.
Application of vascular augmentation of the extra-long latissimus dorsi flap through the intercostal artery in repair of limb wound can reduce the incidence of distal flap necrosis and achieve satisfactory effectiveness.
探讨经肋间动脉的超长背阔肌肌皮瓣血运增强术在肢体创面修复中的临床应用。
2016年1月至2017年12月，对5例肢体创面患者采用超长背阔肌肌皮瓣修复，术中应用经肋间动脉的超长背阔肌肌皮瓣血运增强术。男4例，女1例，平均年龄45.8岁（43～59岁）。创伤后入院至皮瓣修复时间为7～25天，平均12.3天。致伤原因：机器伤2例，交通事故伤2例，碾压伤1例。创面位于上肢前部3例，上肢后部1例，小腿后部1例。创面大小为26 cm×8 cm至38 cm×10 cm。背阔肌肌皮瓣大小为36 cm×6 cm至43 cm×7 cm。肌瓣大小为36 cm×10 cm至43 cm×15 cm。供区直接缝合。
1例皮瓣远端坏死，经对症处理后愈合。其余皮瓣全部成活。供区创面及切口均一期愈合。所有患者均获随访，随访时间8～18个月，平均14.9个月。末次随访时，皮瓣外观、质地及出汗功能均满意。
经肋间动脉的超长背阔肌肌皮瓣血运增强术应用于肢体创面修复，可降低皮瓣远端坏死发生率，效果满意。
