Onuma Haruka, Fuse Yuma, Karakawa Ryo, Yano Tomoyuki, Yoshimatsu Hidehiko
From the Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2023 Jul 12;11(7):e5115. doi: 10.1097/GOX.0000000000005115. eCollection 2023 Jul.
The superficial circumflex iliac artery perforator (SCIP) flap is useful for covering defects in the extremities because its pedicle size can match many recipient options. However, when harvesting a large flap, skin grafting of the donor site is not highly recommended because of the mobility of the hip joint and occasional lymphorrhea. Here, we present a case of a successful reconstruction of a defect in the lower leg after sarcoma resection, using a large SCIP flap. A 58-year-old man underwent resection of a large soft tissue tumor in the lower leg, resulting in a 16 × 14 cm defect. A 25 × 14 cm SCIP flap was harvested from the groin, and the superficial circumflex iliac artery and the superficial circumflex iliac vein were anastomosed to the saphenous artery and the great saphenous vein, respectively, in an end-to-end fashion. For coverage of the groin donor site, a 25 × 8 cm pedicled anterolateral thigh (ALT) flap was harvested from the ipsilateral lateral thigh and was pulled through a subcutaneous tunnel to the groin. The additional operative time for pedicled ALT flap elevation and transfer was approximately 15 minutes. With this pedicled ALT flap, the donor site of the SCIP flap could be closed directly over a drain. The follow-up at 3 months showed complete survival of both flaps, and the patient was able to walk with a cane. The pedicled ALT flap allows for direct closure of the donor site after a large SCIP flap harvest.
旋髂浅动脉穿支（SCIP）皮瓣可用于覆盖肢体缺损，因为其蒂部大小能与多种受区选择相匹配。然而，切取大皮瓣时，由于髋关节的活动度以及偶尔出现的淋巴漏，不十分推荐对供区进行植皮。在此，我们报告1例使用大SCIP皮瓣成功修复小腿肉瘤切除术后缺损的病例。一名58岁男性接受了小腿部一个大的软组织肿瘤切除术，造成了一个16×14cm的缺损。从腹股沟切取一个25×14cm的SCIP皮瓣，将旋髂浅动脉和旋髂浅静脉分别与大隐动脉和大隐静脉进行端端吻合。为了覆盖腹股沟供区，从同侧大腿外侧切取一个25×8cm的带蒂股前外侧（ALT）皮瓣，并通过皮下隧道拉至腹股沟。带蒂ALT皮瓣掀起和转移的额外手术时间约为15分钟。使用该带蒂ALT皮瓣，SCIP皮瓣的供区可在放置引流管的情况下直接闭合。3个月的随访显示两个皮瓣均完全存活，患者能够拄拐行走。带蒂ALT皮瓣使得在切取大的SCIP皮瓣后供区能够直接闭合。
