Ha Yooseok, Park Ji Ah, Kim Youn Hwan
Department of Plastic and Reconstructive Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
Design Lab of Technology Commercialization Center, Industry-University Cooperation Foundation of Hanyang University, Seoul, Republic of Korea.
ANZ J Surg. 2025 Mar;95(3):533-538. doi: 10.1111/ans.70035. Epub 2025 Mar 4.
This study explores a novel technique combining transposition flaps with Split-Thickness Skin Grafts (STSG) to enhance anastomosis site coverage in free tissue transfer surgeries, particularly in lower limb reconstructions using Thoracodorsal Artery Perforator (TDAP) free flap procedures. This method aims to alleviate tension at the anastomosis sites, a common issue affecting reconstructive surgery success.
A retrospective analysis was conducted on 20 patients who underwent TDAP free flap procedures. These cases were chosen due to the anticipated tension at anastomosis sites, necessitating the use of transposition flaps and STSG. Surgical procedures were meticulously documented, and postoperative outcomes were monitored, focusing on complications and overall surgical success.
The study found no instances of complete flap failure, indicating the potential efficacy of the combined approach. Minor complications included two cases of partial tip necrosis in the transposition flaps and two cases of partial graft loss in the STSGs. These issues were resolved through secondary intention healing, demonstrating the technique's ability to manage minor postoperative challenges and maintain flap viability.
Integrating transposition flaps with STSG significantly improves tension management at anastomosis sites in TDAP free flap procedures. This technique not only reduces immediate postoperative complications but also supports the long-term success of reconstructive surgeries. The findings advocate for further research to confirm the efficacy of this approach in microsurgical applications, aiming to enhance patient outcomes and advance reconstructive microsurgery.
本研究探索一种将转位皮瓣与中厚皮片移植（STSG）相结合的新技术，以提高游离组织移植手术中吻合部位的覆盖效果，特别是在使用胸背动脉穿支（TDAP）游离皮瓣进行下肢重建的手术中。该方法旨在缓解吻合部位的张力，这是影响重建手术成功的一个常见问题。
对20例行TDAP游离皮瓣手术的患者进行回顾性分析。选择这些病例是因为预计吻合部位会有张力，需要使用转位皮瓣和STSG。对手术过程进行了详细记录，并对术后结果进行了监测，重点关注并发症和整体手术成功率。
研究发现没有皮瓣完全坏死的情况，表明联合方法具有潜在疗效。轻微并发症包括2例转位皮瓣部分尖端坏死和2例STSG部分植皮丢失。这些问题通过二期愈合得到解决，表明该技术能够应对轻微的术后挑战并维持皮瓣的存活能力。
在TDAP游离皮瓣手术中，将转位皮瓣与STSG相结合可显著改善吻合部位的张力管理。该技术不仅能减少术后即刻并发症，还能支持重建手术的长期成功。研究结果提倡进一步开展研究，以证实该方法在显微外科应用中的疗效，旨在改善患者预后并推动重建显微外科的发展。
