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穿支蒂V-Y皮瓣与穿支蒂螺旋桨皮瓣修复小面积软组织缺损的临床疗效比较:一项回顾性对照研究

Comparison of the Clinical Efficacy of Perforator Pedicled V-Y Flap and Perforator Pedicled Propeller Flap in Repairing Small Area Soft Tissue Defects: A Retrospective Comparative Study.

作者信息

Cao Zhe-Ming, Yang Yan, Xiao Yu, Qing Li-Ming, Tang Ju-Yu, Wu Pan-Feng

机构信息

Department of Orthopedics Xiangya Hospital, Central South University Changsha Hunan China.

National Clinical Research Center of Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China.

出版信息

Health Sci Rep. 2025 Apr 24;8(4):e70693. doi: 10.1002/hsr2.70693. eCollection 2025 Apr.

DOI:10.1002/hsr2.70693
PMID:40276129
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12019873/
Abstract

BACKGROUND AND AIMS

Primary medical institutions commonly employ perforator-pedicled propeller (PPP) flaps and V-Y flaps as the main methods for managing small soft tissue defects resulting from trauma or lesion resection. However, both surgical techniques have inherent limitations. Therefore, this study aims to investigate the feasibility of utilizing perforator-pedicled (PP) V-Y flaps for reconstructing small area soft tissue defects and evaluate their clinical effectiveness.

METHODS

The study conducted a retrospective analysis from January 2010 to December 2022, involving 49 patients with small soft tissue defects resulting from trauma or lesion resection (21 PP V-Y flaps and 28 PPP flaps). Evaluation criteria encompassed intraoperative conditions, postoperative short- and long-term complications, and aesthetic outcomes.

RESULTS

The results of this study showed that all flaps in the PP V-Y flap group survived, while six cases in the PPP flap group had partial necrosis. The donor area was closed directly in one stage for the group of perforator pedicled V-Y flaps, while skin grafting was required to repair the donor area for eight cases from the group of PPP flaps, leading to delayed healing in this region. Furthermore, aesthetic evaluation favored PP V-Y flaps as they exhibited significantly better appearances in both donor and recipient areas.

CONCLUSION

In this study, compared to the PPP flap, the PP V-Y flap demonstrates superior outcomes with regard to reduced postoperative complications and enhanced aesthetic appearance. PP V-Y flap is an ideal technique for repairing small soft tissue defects of limbs, which is suitable for implementation in primary medical institutions. III, Case-control study.

摘要

背景与目的

基层医疗机构通常采用穿支蒂螺旋桨皮瓣(PPP皮瓣)和V-Y皮瓣作为处理创伤或病变切除后所致小面积软组织缺损的主要方法。然而,这两种手术技术都有其固有的局限性。因此,本研究旨在探讨采用穿支蒂(PP)V-Y皮瓣修复小面积软组织缺损的可行性,并评估其临床效果。

方法

本研究对2010年1月至2022年12月期间49例因创伤或病变切除导致小面积软组织缺损的患者进行了回顾性分析(其中21例采用PP V-Y皮瓣,28例采用PPP皮瓣)。评估标准包括术中情况、术后短期和长期并发症以及美学效果。

结果

本研究结果显示,PP V-Y皮瓣组所有皮瓣均存活,而PPP皮瓣组有6例出现部分坏死。穿支蒂V-Y皮瓣组供区一期直接闭合,而PPP皮瓣组有8例需要植皮修复供区,导致该区域愈合延迟。此外,美学评价更倾向于PP V-Y皮瓣,因为它们在供区和受区的外观均明显更好。

结论

在本研究中,与PPP皮瓣相比,PP V-Y皮瓣在减少术后并发症和改善美学外观方面表现出更好的效果。PP V-Y皮瓣是修复四肢小面积软组织缺损的理想技术,适合在基层医疗机构开展。III,病例对照研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/e5204b049b6f/HSR2-8-e70693-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/5249a4d586e8/HSR2-8-e70693-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/6083bcb019b0/HSR2-8-e70693-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/2823b3edfc9d/HSR2-8-e70693-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/8a6103a6dd65/HSR2-8-e70693-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/b13b2d8c81ac/HSR2-8-e70693-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/3f14e7bb905d/HSR2-8-e70693-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/e5204b049b6f/HSR2-8-e70693-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/5249a4d586e8/HSR2-8-e70693-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/6083bcb019b0/HSR2-8-e70693-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/2823b3edfc9d/HSR2-8-e70693-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/8a6103a6dd65/HSR2-8-e70693-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/b13b2d8c81ac/HSR2-8-e70693-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/3f14e7bb905d/HSR2-8-e70693-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3c/12019873/e5204b049b6f/HSR2-8-e70693-g004.jpg

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本文引用的文献

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Front Surg. 2024 May 13;11:1364340. doi: 10.3389/fsurg.2024.1364340. eCollection 2024.
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Repairing of recurrent leg ulcer induced by hydroxyurea with posterior tibial artery perforator propeller flap: Case report.
Int J Surg Case Rep. 2024 Jan;114:109049. doi: 10.1016/j.ijscr.2023.109049. Epub 2023 Nov 23.
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Plastic Surgery Reconstruction of Sarcoma Resection Defects: Form and Function.肉瘤切除术后缺损的整形重建:形态与功能。
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One- and two-staged Pacman V-Y advancement flaps for defects of the head and neck: A review of 29 cases.单、双阶段 Pacman V-Y 推进皮瓣在头颈部缺损中的应用:29 例回顾。
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