Liu Y, Song D J, Xie S L, Song T, Zhang W T, Tian X N, Cong F, Du X L, Chen X, Fan J Z, Hao D J
Medical Department of Xi'an Jiaotong University, Xi'an 710000, China (is working at the Department of Bone Microsurgery, Xi'an Honghui hospital, Xi'an 710054, China).
Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Changsha 410008, China.
Zhonghua Shao Shang Za Zhi. 2020 Jul 20;36(7):590-593. doi: 10.3760/cma.j.cn501120-20190415-00185.
To explore the feasibility and clinical effects of using free thinned deep inferior epigastric artery perforator flap to repair extensive soft tissue defects in extremities. From April 2010 to January 2014, 12 patients with extensive soft tissue defect in extremities after trauma, including 10 males and 2 females, aged 21 to 48 years, 6 patients with defect in the back of wrist and 6 patients with defect in ankle were admitted to the Department of Bone Microsurgery of Xi'an Honghui hospital. After debridement, the size of soft tissue defect ranged from 15.0 cm×4.5 cm to 28.0 cm×11.0 cm. The free thinned deep inferior epigastric artery perforator flap was designed, cut and transferred for reconstruction, with size of 15.0 cm×5.0 cm to 29.0 cm×12.0 cm. The flap thickness ranged from 4.0 to 6.5 cm before defatting, and was 0.6 to 0.9 cm after defatting. All the donor sites of flaps were closed directly by suturing. The flap survival and the appearance and function of flap and donor site were observed during follow-up. All the flaps survived smoothly after surgery. During follow-up of 10 to 42 months, the flaps showed no bloat in appearance, no further flap revision or defatting procedures were required, the distance of static 2-point discrimination was 11 to 17 mm (14.5 mm on average). The abdominal function of patients was not affected, and no postoperative abdomen hernia or ulceration was noted. The free thinned deep inferior epigastric artery perforator flap is thin and suitable for repairing extensive soft tissue defects in extremities with very good outcomes.
探讨采用游离超薄腹壁下动脉穿支皮瓣修复四肢大面积软组织缺损的可行性及临床效果。2010年4月至2014年1月，西安红会医院骨显微外科收治12例四肢创伤后大面积软组织缺损患者，其中男10例，女2例，年龄21～48岁，腕背部缺损6例，踝部缺损6例。清创后，软组织缺损面积为15.0 cm×4.5 cm至28.0 cm×11.0 cm。设计、切取并转移游离超薄腹壁下动脉穿支皮瓣进行修复，皮瓣大小为15.0 cm×5.0 cm至29.0 cm×12.0 cm。皮瓣去脂前厚度为4.0～6.5 cm，去脂后为0.6～0.9 cm。所有皮瓣供区均直接缝合关闭。随访观察皮瓣存活情况及皮瓣和供区的外观与功能。术后所有皮瓣均顺利存活。随访10～42个月，皮瓣外观无臃肿，无需进一步修薄或去脂处理，静态两点辨别觉距离为11～17 mm（平均14.5 mm）。患者腹部功能未受影响，未出现术后腹壁疝或溃疡。游离超薄腹壁下动脉穿支皮瓣质地薄，适合修复四肢大面积软组织缺损，效果良好。
