Tang Juyu, He Jiqiang, Wu Panfeng, Zhou Zhengbing, Yu Fang, Qing Liming, Pan Ding, Pang Xiaoyang, Zeng Lei, Xiao Yongbing, Liu Rui
Department of Hand and Microsurgery, Xiangya Hospital, Central South University, Changsha Hunan, 410008,
Department of Hand and Microsurgery, Xiangya Hospital, Central South University, Changsha Hunan, 410008, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Apr 15;33(4):467-470. doi: 10.7507/1002-1892.201811103.
To investigate the feasibility and effectiveness of the superior lateral genicular artery perforator flap for repairing of soft tissue defects in extremities.
Between September 2010 and October 2017, 11 cases of skin and soft tissue in extremities were repaired with the superior lateral genicular artery perforator flap. There were 10 males and 1 female, with an average age of 37.6 years (range, 6-72 years). The causes of injury were traffic accident in 6 cases, machine injury in 1 case, falling down injury in 1 case, falling from height in 1 case, crushing injury in 1 case, and electric injury in 1 case. The defects located at the forearm in 1 case, knee in 5 cases, popliteal fossa in 2 cases, shank in 1 case, and foot and ankle in 2 cases. The area of the wound ranged from 8.0 cm×4.5 cm to 27.0 cm×8.0 cm. The interval from injury to admission was 6 days on average (range, 3-12 days). The area of perforator flap ranged from 9.0 cm×5.5 cm to 28.0 cm×9.0 cm. There were 8 cases of pedicle flap and 3 cases of free flap. All the donor sites were closed directly.
Eight flaps survived without any complications and the donor sites healed by first intention. Two flaps had arterial crisis and 1 flap had venous crisis after operation, and the wounds healed after symptomatic treatment. There was no hematoma and secondary infections in all patients after operation. Ten patients were followed up 2-48 months (mean, 13.1 months). All flaps had satisfied appearance and texture. There was no motion limitations in the hip and knee joints of the operated legs.
The superior lateral genicular artery perforator flap not only can be used to repair the soft tissue defect around the knee joint as pedicle flap, but also can be used to repair the forearm and foot skin and soft tissue defects as free flap, which is a feasible way to repair soft tissue defects in extremities.
探讨膝外上动脉穿支皮瓣修复四肢软组织缺损的可行性及有效性。
2010年9月至2017年10月，采用膝外上动脉穿支皮瓣修复四肢皮肤软组织缺损11例。男10例，女1例，平均年龄37.6岁（6～72岁）。致伤原因：交通事故6例，机器伤1例，跌伤1例，高处坠落伤1例，挤压伤1例，电击伤1例。缺损位于前臂1例，膝关节5例，腘窝2例，小腿1例，足踝部2例。创面面积8.0 cm×4.5 cm～27.0 cm×8.0 cm。受伤至入院时间平均6天（3～12天）。穿支皮瓣面积9.0 cm×5.5 cm～28.0 cm×9.0 cm。带蒂皮瓣8例，游离皮瓣3例。所有供区均直接缝合。
8例皮瓣全部成活，无并发症，供区一期愈合。术后2例皮瓣发生动脉危象，1例发生静脉危象，经对症处理后创面愈合。所有患者术后均无血肿及继发感染。10例患者获随访2～48个月，平均13.1个月。所有皮瓣外形及质地满意。术侧髋、膝关节无活动受限。
膝外上动脉穿支皮瓣不仅可作为带蒂皮瓣用于修复膝关节周围软组织缺损，还可作为游离皮瓣用于修复前臂及足部皮肤软组织缺损，是修复四肢软组织缺损的一种可行方法。
