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应用腹壁下浅动脉皮瓣修复下肢及足部大面积软组织缺损

Coverage of large soft tissue defects of the lower limb and foot with superficial inferior epigastric artery flap.

作者信息

Liu Dong, Xie Xingwen, Chu Ping An, Zhou Xin, Luo Lin, Li Ning

机构信息

School of Clinical Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China.

Department of Orthopaedics, The Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China.

出版信息

Front Surg. 2024 Oct 24;11:1424681. doi: 10.3389/fsurg.2024.1424681. eCollection 2024.

Abstract

BACKGROUND

Large soft tissue defects of the lower limb and foot are common occurrence in clinical practice and a considerable number of flaps have been used to treat them. However, there have been few reports using the superficial inferior epigastric artery (SIEA) flap. This review aims to present the experience of using the SIEA flaps for the repair of large soft tissue defects of the lower limb and foot.

METHODS

A retrospective review of data from 11 patients who underwent coverage of lower limb and foot defects exceeding 120 cm (15 × 9 cm) using SIEA flaps from March 2018 to July 2022 were retrospectively reviewed. The average size of the defects was 18 × 11 cm (range 15 × 9 cm-32 × 16 cm). Flap survival rates, surgical complications and overall long-term outcomes were recorded.

RESULTS

All 11 flaps survived. One flap was partially necrotic at the edge and healed after several changes of dressing. Additionally, one flap presented with mild venous congestion. The mean follow-up period was 18 months (ranging from 12 to 30 months). The mean size of the flaps was 20 × 12 cm (range 17 × 9 cm-34 × 18 cm). The flaps were observed to be aesthetically pleasing and exhibited a well-defined texture. The donor wounds were successfully closed primarily, with only linear scarring remaining.

CONCLUSIONS

The SIEA flap is characterised by concealed donor area, superficial vascular location, easy access and primary closure, which results in favourable aesthetic outcomes. It is an appropriate choice for the repair of large soft tissue defects of the lower limb and foot.

摘要

背景

下肢和足部的大面积软组织缺损在临床实践中很常见,已有相当数量的皮瓣用于治疗此类缺损。然而,使用腹壁下浅动脉(SIEA)皮瓣的报道较少。本综述旨在介绍使用SIEA皮瓣修复下肢和足部大面积软组织缺损的经验。

方法

回顾性分析2018年3月至2022年7月期间11例行SIEA皮瓣修复下肢和足部超过120平方厘米(15×9厘米)缺损患者的数据。缺损平均大小为18×11厘米(范围15×9厘米至32×16厘米)。记录皮瓣存活率、手术并发症及总体长期预后情况。

结果

11例皮瓣全部存活。1例皮瓣边缘部分坏死,经多次换药后愈合。此外,1例皮瓣出现轻度静脉淤血。平均随访时间为18个月(12至30个月)。皮瓣平均大小为20×12厘米(范围17×9厘米至34×18厘米)。观察发现皮瓣外形美观,质地清晰。供区伤口一期成功闭合,仅留线性瘢痕。

结论

SIEA皮瓣具有供区隐蔽、血管位置表浅、易于切取及一期闭合等特点,美学效果良好。是修复下肢和足部大面积软组织缺损的合适选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f755/11540551/df1a9f3c9fbc/fsurg-11-1424681-g001.jpg

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