Zhou Zhegang, Yu Longbiao, Meng Fanbin, Wen Jingjing, Xiao Yingfeng, Wan Shengxiang, Zeng Hui, Yu Fei
From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China.
Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen, China.
Plast Reconstr Surg Glob Open. 2024 Nov 21;12(11):e6337. doi: 10.1097/GOX.0000000000006337. eCollection 2024 Nov.
This study was conducted to compare the incidence of postoperative complications related to blood circulation in the treatment of skin defects through the transfer of ultrathin anterolateral thigh (ALT) flaps or conventional ALT flaps.
Patients who received ultrathin ALT flap transfer (group A) and conventional ALT flap transfer (group B) due to skin defects at Peking University Shenzhen Hospital from January 2016 to January 2023 were included in this study. The postoperative incidence of ecchymosis, vascular crisis (artery or vein), and flap survival were compared between the 2 groups of patients.
In group A, 27 patients recovered and 8 patients reported ecchymosis. In addition, 32 patients achieved flap survival, 1 patient had partial flap necrosis, and 2 patients had complete flap necrosis. In group B, 61 patients recovered and 6 patients reported ecchymosis. In addition, 65 patients achieved flap survival, 1 patient had partial flap necrosis, and 1 patient had complete flap necrosis. Compared with group B, the incidence of ecchymosis was significantly higher in group A ( < 0.05).
Postoperative blood circulation monitoring (especially ecchymosis) is an important part of postoperative nursing observation in the treatment of skin defects with ultrathin ALT flap transfer. There is no significant difference in the incidence of postoperative vascular crisis between ultrathin and conventional ALT flap transfer. However, the incidence of nonvenous crisis ecchymosis after ultrathin ALT flap transfer is significantly higher than that after conventional ALT flap transfer.
本研究旨在比较通过超薄股前外侧(ALT)皮瓣转移或传统ALT皮瓣治疗皮肤缺损时与血液循环相关的术后并发症发生率。
纳入2016年1月至2023年1月在北京大学深圳医院因皮肤缺损接受超薄ALT皮瓣转移(A组)和传统ALT皮瓣转移(B组)的患者。比较两组患者术后瘀斑、血管危象(动脉或静脉)发生率及皮瓣存活情况。
A组27例患者恢复,8例出现瘀斑。此外,32例皮瓣存活,1例皮瓣部分坏死,2例皮瓣完全坏死。B组61例患者恢复,6例出现瘀斑。此外,65例皮瓣存活,1例皮瓣部分坏死,1例皮瓣完全坏死。与B组相比,A组瘀斑发生率显著更高(<0.05)。
术后血液循环监测(尤其是瘀斑)是超薄ALT皮瓣转移治疗皮肤缺损术后护理观察的重要内容。超薄ALT皮瓣转移与传统ALT皮瓣转移术后血管危象发生率无显著差异。然而,超薄ALT皮瓣转移后非静脉危象瘀斑发生率显著高于传统ALT皮瓣转移后。