Pan D J, Jiang W, Li H W
Department of Burns and Plastic Surgery, Dali Bai Autonomous Prefecture People's Hospital, Dali 671000, China.
Zhonghua Shao Shang Za Zhi. 2020 Jan 20;36(1):67-69. doi: 10.3760/cma.j.issn.1009-2587.2020.01.013.
On October 23, 2017, a 52-year-old male patient with 3 recurrences of dermatofibrosarcoma protuberans in the left shoulder and chest was admitted to the Department of Burns and Plastic Surgery of Dali Bai Autonomous Prefecture People's Hospital. Dermatofibrosarcoma protuberans on the skin were completely resected, leaving wound defect of 10 cm×10 cm. The wound was planned to be repaired by the transplantation of right anterolateral thigh perforator free flap. However, the anterolateral thigh perforator branch was absent during flap removal, and only one small perforating branch was found. Moreover, it was difficult to separate. Therefore, this flap cutting was given up. The anteromedial thigh perforator was explored through the same incision, and a thicker perforator was found, which was supplied by an independent iatrogenic artery. The length and diameter of the vascular pedicle matched with the blood vessels in the receiving site. An anteromedial thigh perforator flap (10 cm×10 cm) was cut to repair the defect. The postoperative 9-month follow-up revealed that the color, texture, and thickness of the flap were good, the two-point discrimination distance was 30 mm, and the linear scar remained at the donor site of right thigh.
2017年10月23日，一名左肩部和胸部复发性隆突性皮肤纤维肉瘤3次复发的52岁男性患者入住大理白族自治州人民医院烧伤整形科。对皮肤上的隆突性皮肤纤维肉瘤进行了完整切除，留下10 cm×10 cm的创面缺损。计划采用右股前外侧穿支游离皮瓣移植修复创面。然而，切取皮瓣时发现股前外侧穿支缺如，仅见1支细小穿支，且分离困难，遂放弃该皮瓣切取。通过原切口探查股内侧穿支，发现1支较粗穿支，由独立的医源性动脉供血，血管蒂长度和直径与受区血管相匹配。切取10 cm×10 cm股内侧穿支皮瓣修复缺损。术后9个月随访，皮瓣颜色、质地、厚度良好，两点辨别觉距离为30 mm，右大腿供区遗留线状瘢痕。
