带蒂股前外侧皮瓣在区域性缺损重建中的疗效——记录分析。

Efficacy of pedicled anterolateral thigh flap for reconstruction of regional defects - a record analysis.

出版信息

Acta Chir Plast. 2022 Spring;64(1):6-11. doi: 10.48095/ccachp20226.

DOI:10.48095/ccachp20226

Abstract

BACKGROUND

The anterolateral thigh (ALT) flap was described as the fasciocutaneous flap. It can be harvested as a pedicled and/or free flap. Majority of the free flaps are harvested as a fasciocutaneous flap. Their use in head and neck reconstruction and limb trauma is well established. Apart from these advantages, this flap has various applications which are less utilized. ALT flap can be used as a myocutaneous flap along with vastus lateralis muscle. When muscle and fasciocutaneous flaps are required, both can be harvested as a chimeric flap which can cover two different regions of the wound. Moreover, harvest of the pedicled flap procedure is less time-consuming than that of a free flap. Since it has a long vascular pedicle, when used as pedicled flap, it can reach up to the gluteal region. To evaluate these less applied advantages of pedicled ALT flap, our study was undertaken. This study aimed to evaluate the efficiency of ALT flap in terms of the surface area of coverage, arc of rotation and the advantages of including vastus lateralis muscle as part of the flap.

METHODS

A retrospective record analysis of all pedicled ALT flap reconstruction of trochanteric, upper thigh, gluteal and flank regions from 2016 to 2018 was undertaken; 7 patients with 8 defects were included.

RESULTS

All the flaps healed successfully. There was no major necrosis of the flap and minor complications like wound gapping were found in three patients.

CONCLUSION

The ALT-vastus lateralis flap dimensions can be very large and can be easily harvested in a very short time. Vastus lateralis muscle harvested can be used to fill the defect or can be used as chimera to cover the defect. The use of muscle over long standing infective pressure sores can sterilize the wound bed and help in preventing recurrence. The vascularity of this flap is robust and highly reliable. Even after a maximum arc of rotation (up to 170°) all the flaps survived without any major complications.

摘要

背景

前外侧大腿（ALT）皮瓣被描述为筋膜皮瓣。它可以作为带蒂或游离皮瓣进行采集。大多数游离皮瓣都是作为筋膜皮瓣采集的。它们在头颈部重建和四肢创伤中的应用已得到充分证实。除了这些优点之外，这种皮瓣还有各种应用，但其应用并不广泛。ALT 皮瓣可以与股外侧肌一起作为肌皮瓣使用。当需要肌肉和筋膜皮瓣时，可以将两者作为嵌合皮瓣一起采集，以覆盖伤口的两个不同区域。此外，带蒂皮瓣的采集过程比游离皮瓣耗时更少。由于它有一个较长的血管蒂，当用作带蒂皮瓣时，它可以到达臀部区域。为了评估带蒂 ALT 皮瓣的这些较少应用的优点，我们进行了这项研究。本研究旨在评估 ALT 皮瓣在覆盖面积、旋转弧和包含股外侧肌作为皮瓣一部分的优势方面的效率。