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游离带血管蒂阔筋膜张肌皮瓣联合植皮修复足背复杂缺损1例报告

Free vascularized fascia lata flap combined with skin grafting for reconstruction of complex defect of the foot dorsum - A case report.

作者信息

Sơn Trần Thiết, Tuấn Nguyễn Ngọc, Minh Nguyễn Đinh, Thuý Tạ Thị Hồng, Nghĩa Phan Tuấn

机构信息

Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Viet Nam; Department of Plastic Reconstructive and Aesthetic Surgery, University of Medicine and Pharmacy, Hanoi National University, Viet Nam; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Viet Nam.

Department of Plastic Reconstructive and Aesthetic Surgery, University of Medicine and Pharmacy, Hanoi National University, Viet Nam; Department of Plastic Reconstructive and Aesthetic Surgery, E Hospital, Hanoi, Viet Nam.

出版信息

Int J Surg Case Rep. 2025 Apr;129:111124. doi: 10.1016/j.ijscr.2025.111124. Epub 2025 Mar 4.

DOI:10.1016/j.ijscr.2025.111124
PMID:40048964
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11928999/
Abstract

INTRODUCTION

The dorsum of the foot has distinct characteristics, including thin skin and minimal subcutaneous tissue. Injuries in this area can expose deeper structures, complicating recovery and increasing the risk of infection and tissue necrosis. This article discusses using a free vascularized fascia lata (FL) flap combined with a skin graft to achieve effective skin coverage in a single stage.

CASE PRESENTATION

A patient with a defect on the foot's dorsum, which exposed the extensor tendons, was reconstructed using the FL flap alongside a full-thickness skin graft. The results showed satisfactory functional and aesthetic outcomes.

DISCUSSION

The fasciocutaneous anterolateral thigh (ALT) free flap is an effective option for foot reconstruction, offering benefits such as resistance to infection and quicker healing. However, its thickness may require a secondary procedure for aesthetic refinement. The vascularized FL flap has proven to be an excellent choice for reconstructive surgery due to its thin, pliable nature and reliable blood supply, resulting in low donor site morbidity.

CONCLUSION

The vascularized FL flap, combined with full-thickness skin grafts, is a viable alternative for reconstructing complex wounds involving exposed tendons and can.

摘要

引言

足背具有独特的特征，包括皮肤薄且皮下组织少。该区域的损伤会暴露更深层的结构，使恢复过程复杂化，并增加感染和组织坏死的风险。本文讨论使用带血管蒂的阔筋膜张肌（FL）皮瓣联合皮肤移植在一期实现有效的皮肤覆盖。

病例介绍

一名足背缺损患者，伸肌腱外露，采用FL皮瓣联合全厚皮片进行重建。结果显示功能和美学效果均令人满意。

讨论

股前外侧（ALT）游离筋膜皮瓣是足部重建的有效选择，具有抗感染和愈合快等优点。然而，其厚度可能需要二次手术进行美学优化。带血管蒂的FL皮瓣因其薄、柔韧的特性和可靠的血供，已被证明是重建手术的理想选择，供区并发症发生率低。

结论

带血管蒂的FL皮瓣联合全厚皮片是修复涉及外露肌腱和关节的复杂伤口的可行替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/89e1182a436b/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/89344dc05703/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/157d6e479cce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/e80e96ab6ad7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/2553a1f47578/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/89e1182a436b/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/89344dc05703/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/157d6e479cce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/e80e96ab6ad7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/2553a1f47578/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb8/11928999/89e1182a436b/gr5.jpg

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