Zaussinger Maximilian, Wenny Raphael, Huemer Georg M, Schmidt Manfred
Section of Plastic and Reconstructive Surgery, Department of General Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; Johannes Kepler University Linz, Medical Faculty, Altenbergerstr. 69, 4040 Linz, Austria.
Section of Plastic and Reconstructive Surgery, Department of General Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; Johannes Kepler University Linz, Medical Faculty, Altenbergerstr. 69, 4040 Linz, Austria.
J Plast Reconstr Aesthet Surg. 2022 Aug;75(8):2493-2500. doi: 10.1016/j.bjps.2022.02.077. Epub 2022 Mar 8.
The wide range of reconstructive purposes requires specific demands and considerations for appropriate flap selection. One versatile and reliable option, which is rarely reported in current literature, is the fasciocutaneous infragluteal (FCI) flap. In this study, we present our results of performing the FCI flap for different clinical indications.
This retrospectively study was conducted between September 2011 and September 2019. We included 30 patients (21 females and 9 males) who underwent reconstruction with either pedicled or free FCI flap. Indications for performing FCI flap were uni- or bilateral autologous breast reconstruction, perineal reconstruction, congenital thoracic deformity, lower extremity coverage, and vulva reconstruction.
Forty-one FCI flaps were performed (34 free and 7 pedicled flaps). The average flap dimension was 7 × 20 cm (range, 7-8 × 19-21) and the mean length of the pedicle was 13.4 cm (range, 10.5-15.5). The mean diameter of the artery was 2.5 mm (range, 2.2-3.2), the mean diameter of the accompanying vein was 3 mm (range, 2.4-3.3). The flap survival rate was 97.6% (one flap loss). The most common minor complications were infragluteal wound healing disorders and hematoma.
The FCI flap provides constant and reliable anatomy with a long vascular pedicle as well as enough soft tissue bulk and a well-hidden scar. In our clinical practice, this flap has emerged as a first choice in perineal/vulvar reconstruction and a reliable alternative in breast reconstruction if the gold standard procedure cannot be performed.
IV (Therapeutic).
广泛的重建目的对合适皮瓣的选择提出了特定要求和考量。一种多功能且可靠的选择——臀下筋膜皮瓣（FCI皮瓣），在当前文献中鲜有报道。在本研究中，我们展示了针对不同临床适应证施行FCI皮瓣的结果。
本回顾性研究于2011年9月至2019年9月进行。我们纳入了30例患者（21例女性和9例男性），他们接受了带蒂或游离FCI皮瓣重建术。施行FCI皮瓣的适应证包括单侧或双侧自体乳房重建、会阴重建、先天性胸廓畸形、下肢覆盖以及外阴重建。
共施行41例FCI皮瓣（34例游离皮瓣和7例带蒂皮瓣）。皮瓣平均尺寸为7×20cm（范围为7 - 8×19 - 21），蒂的平均长度为13.4cm（范围为10.5 - 15.5）。动脉平均直径为2.5mm（范围为2.2 - 3.2），伴行静脉平均直径为3mm（范围为2.4 - 3.3）。皮瓣存活率为97.6%（1例皮瓣坏死）。最常见的轻微并发症是臀下伤口愈合障碍和血肿。
FCI皮瓣具有恒定且可靠的解剖结构、较长的血管蒂、足够的软组织量以及隐蔽的瘢痕。在我们的临床实践中，该皮瓣已成为会阴/外阴重建的首选，并且在无法施行金标准手术时是乳房重建的可靠替代方案。
IV（治疗性）。
