Boissière Florian, Luca-Pozner Vlad, Vaysse Charlotte, Kerfant Nathalie, Herlin Christian, Chaput Benoit
Department of Plastic and Reconstructive Surgery, Burns and Wound Healing Units, CHRU Lapeyronie, Montpellier, France.
Department of General and Gynaecological Surgery, Rangueil University Hospital, 1 Av Pr Poulhès, 31059 Toulouse, France.
J Plast Reconstr Aesthet Surg. 2019 Jul;72(7):1121-1128. doi: 10.1016/j.bjps.2019.03.016. Epub 2019 Apr 1.
Abdominopelvic defect is frequently a challenge. Several local flaps exist for this anatomical region, but sequelae of the donor site, particularly with regard to morbidity on the anterior abdominal wall, are frequent. Although the utility of the superficial circumflex iliac artery flap is well established in its free form as well as its pedicled form described by McGregor, the superficial circumflex iliac artery perforator (SCIP) propeller flap is rarely reported. The purpose of this study is to highlight the possible range of locoregional coverage using the SCIP propeller flap.
Between 2012 and 2018, 72 SCIP flaps were made in the propeller version to cover locoregional defects of various etiologies in our units.
The dimensions of SCIP flaps were on average 20.2 cm long (9-39) by 8.2 cm wide (5-18). The average rotation angle was 163.3° (range 130-180). In sixteen patients, SCIP flaps were bilateral. In five cases, the reconstruction was combined with a contralateral Tensor Fascia Lata (TFL) flap to cover a very large defect. Two SCIP flaps necrotized following global venous congestion and a TFL flap was performed in rescue. No complications appeared on the donor site and the patients did not have any functional complications related to the reconstruction. Particular care was taken to respect the lateral cutaneous nerve of the thigh.
The SCIP propeller flap provides a reliable and versatile method for reconstructing abdominoperineal defect, including the thigh root region to the trochanters with low donor site morbidity.
腹盆腔缺损常常是一项挑战。该解剖区域有多种局部皮瓣,但供区的后遗症很常见,尤其是在前腹壁的发病率方面。尽管旋髂浅动脉皮瓣在游离形式以及麦格雷戈描述的带蒂形式中都已得到充分应用,但旋髂浅动脉穿支(SCIP)推进皮瓣的报道却很少。本研究的目的是强调使用SCIP推进皮瓣进行局部覆盖的可能范围。
2012年至2018年期间,我们单位制作了72个推进式SCIP皮瓣,用于覆盖各种病因导致的局部缺损。
SCIP皮瓣的尺寸平均长20.2厘米(9 - 39厘米),宽8.2厘米(5 - 18厘米)。平均旋转角度为163.3°(范围130 - 180°)。16例患者采用双侧SCIP皮瓣。5例患者的重建手术联合对侧阔筋膜张肌(TFL)皮瓣以覆盖非常大的缺损。2个SCIP皮瓣因全身性静脉淤血而坏死,随后进行了TFL皮瓣挽救手术。供区未出现并发症,患者也没有与重建相关的功能并发症。特别注意保护股外侧皮神经。
SCIP推进皮瓣为重建腹会阴缺损提供了一种可靠且通用的方法,包括从大腿根部到转子区域,供区发病率低。