Department of Plastic, Reconstructive and Aesthetic Surgery, Kocaeli University Faculty of Medicine, Kocaeli-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2022 Dec;28(12):1701-1707. doi: 10.14744/tjtes.2022.97970.
Cross leg free flaps are one of the salvage methods used for free tissue transfer in large tissue defects in the absence of recipient vessels. The fasciocutaneous flap above the posterior tibial artery can be harvested to protect the pedicle and to advance a distance to wound, which is equal to the length of fasciocutaneous flap.
Patients who were operated with cross leg free flap with the supporting fasciocutaneous flap on unwounded side were included in the study between years 2010 and 2020. Age, sex, location and size of the defects, arterial patencies, flap choices, fascio-cutaneous flap size, duration of operation, cross flap separation timing, complications, and time to return to work were evaluated.
There were six patients with the etiology of high-energy electrical burns and trauma. There was only one arterial refilling for three patients and no refilling for others. Latissimus dorsi skin muscle flap was used in all but one patient. The mean defect size was 6.6×14.8 cm. The mean size of fasciocutaneous flaps was 4.08×5 cm. The mean operation time was 360 min. There was no complication except one dehiscence and one marginal necrosis and infection which were healed with wound care. Average time to return to work was 9 months.
In similar cases, as wounded lower extremities with one or no artery refill, harvesting a fasciocutaneous flap with recipient vessels will be useful before considering the option of using a bridge free flap in medium to moderate sized defects.
在没有受区血管的情况下，交叉腿游离皮瓣是用于治疗大组织缺损的游离组织转移的一种挽救方法。可以切取胫后动脉上方的筋膜皮瓣来保护蒂部，并向创面推进一段距离，其长度与筋膜皮瓣相等。
纳入 2010 年至 2020 年期间接受交叉腿游离皮瓣伴未受伤侧支持筋膜皮瓣手术的患者进行研究。评估患者的年龄、性别、缺损部位和大小、动脉通畅情况、皮瓣选择、筋膜皮瓣大小、手术时间、交叉瓣分离时间、并发症以及恢复工作的时间。
患者病因均为高能电烧伤和创伤，3 例患者仅 1 例动脉再充盈，其余患者无再充盈。除 1 例患者外，其余患者均使用了背阔肌皮瓣。平均缺损大小为 6.6×14.8cm，筋膜皮瓣平均大小为 4.08×5cm，平均手术时间为 360min。除 1 例切口裂开和 1 例边缘坏死伴感染外，无其他并发症，经伤口护理后愈合。平均恢复工作时间为 9 个月。
在类似情况下，对于下肢受伤且只有 1 条或没有动脉再充盈的患者，在考虑使用桥接游离皮瓣治疗中重度缺损之前，切取带有受区血管的筋膜皮瓣将是有用的。
