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最大限度发挥腹股沟区域薄皮瓣的多功能性:巧用旋髂浅动脉穿支(SCIP)游离皮瓣和腹壁下动脉浅支(SIEA)游离皮瓣,并进行精确的术前规划。

Maximizing the Versatility of Thin Flap from the Groin Area as a Workhorse Flap: The Selective Use of Superficial Circumflex Iliac Artery Perforator (SCIP) Free Flap and Superficial Inferior Epigastric Artery (SIEA) Free Flap with Precise Preoperative Planning.

机构信息

Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

J Reconstr Microsurg. 2023 Feb;39(2):148-155. doi: 10.1055/a-1887-7274. Epub 2022 Jun 29.

Abstract

BACKGROUND

This study aimed to evaluate the usefulness of the selective use of the superficial circumflex iliac artery perforator (SCIP) and the superficial inferior epigastric artery (SIEA) flap as a workhorse flap from the groin area with precise preoperative surgical planning.

METHODS

A total of 79 free flap reconstructions were performed in the study period; 35 SCIP free flaps and 19 SIEA free flaps were performed in the study period. Detailed preoperative surgical planning was performed using computed tomography (CT) angiography and color Doppler ultrasound. Detailed anatomical information of the flaps and reconstructive outcomes were evaluated.

RESULTS

Flap characteristics between SCIP free flaps and SIEA free flaps were similar. The average transverse distance of the perforator from anterior superior iliac spine was 15.91 cm in SCIP free flaps and 43.15 cm in SIEA free flaps. The overall flap success rate was 96.4%. Majority of the patients achieved satisfactory contour without debulking surgery. Donor site morbidity was minimal with one case of wound dehiscence.

CONCLUSION

The selective use of the SCIP and SIEA free flap in groin area is a safe and useful technique. The surgical outcomes were reliable and similar between the SCIP and SIEA free flaps. Preoperative vascular planning using CT angiography and color Doppler ultrasound is essential for selecting the proper flap.

摘要

背景

本研究旨在评估在精确的术前手术规划下,从腹股沟区域选择性使用旋髂浅动脉穿支(SCIP)和腹壁浅动脉(SIEA)皮瓣作为主力皮瓣的实用性。

方法

研究期间共进行了 79 例游离皮瓣重建;研究期间进行了 35 例 SCIP 游离皮瓣和 19 例 SIEA 游离皮瓣。使用计算机断层扫描(CT)血管造影和彩色多普勒超声进行详细的术前手术规划。评估皮瓣的详细解剖信息和重建结果。

结果

SCIP 游离皮瓣和 SIEA 游离皮瓣的皮瓣特征相似。SCIP 游离皮瓣中穿支从前上髂棘的平均横向距离为 15.91cm,SIEA 游离皮瓣为 43.15cm。总的皮瓣成功率为 96.4%。大多数患者无需整形手术即可获得满意的轮廓。供区并发症发生率低,仅 1 例出现伤口裂开。

结论

腹股沟区域选择性使用 SCIP 和 SIEA 游离皮瓣是一种安全且有用的技术。SCIP 和 SIEA 游离皮瓣的手术结果可靠且相似。使用 CT 血管造影和彩色多普勒超声进行术前血管规划对于选择合适的皮瓣至关重要。

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