Williams J K, Carlson G W, Howell R L, Wagner J D, Nahai F, Coleman J J
Joseph B, Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
J Reconstr Microsurg. 1997 Feb;13(2):83-90; discussion 90-1. doi: 10.1055/s-2007-1000222.
The pedicled tensor fascia lata flap (TFL flap) is a method of choice for abdominal-wall reconstruction. Frequently, the size and location of the defect produce this option. Microsurgical transfer may overcome these disadvantages. Therefore, the ability of the TFL free flap to reconstruct complex abdominal wounds was evaluated. Seven patients with full-thickness abdominal-wall defects reconstructed by TFL free flaps were reviewed. Their average age was 44.6 years (range: 27 years to 59 years); follow-up averaged 10.5 months (range: 2 months to 18 months). Fifty-seven percent of the wounds were either infected or contaminated; the defect averaged 15 cm x 26 cm Six 85.7 percent) of the wounds involved the epigastrum. No total flap loss was seen, but three flaps developed distal tip necrosis (42.9%). Microsurgical transfer of the TFL free flap overcomes the limitations of the arc of rotation seen with the pedicled flap. It increases the vascularity of the distal portion of the flap. The TFL free flap is therefore an option in abdominal wounds, particularly those with defects of large size or supraumbilical location.
带蒂阔筋膜张肌皮瓣（TFL皮瓣）是腹壁重建的一种首选方法。通常，缺损的大小和位置决定了这种选择。显微外科转移可能会克服这些缺点。因此，对TFL游离皮瓣重建复杂腹部伤口的能力进行了评估。回顾了7例采用TFL游离皮瓣重建全层腹壁缺损的患者。他们的平均年龄为44.6岁（范围：27岁至59岁）；平均随访10.5个月（范围：2个月至18个月）。57%的伤口为感染或污染伤口；缺损平均为15 cm×26 cm。85.7%（6例）的伤口累及上腹部。未观察到皮瓣完全坏死，但有3个皮瓣发生远端坏死（42.9%）。TFL游离皮瓣的显微外科转移克服了带蒂皮瓣旋转弧的局限性。它增加了皮瓣远端部分的血运。因此，TFL游离皮瓣是腹部伤口的一种选择，尤其是那些大尺寸或脐上部位缺损的伤口。
