髂腹股沟穿支皮瓣移植修复四肢皮肤软组织缺损

发布时间：2018-03-30 09:16

本文选题：髂腹股沟区　切入点：腹壁浅血管　出处：《中国临床解剖学杂志》2017年02期

【摘要】：目的总结应用移植髂腹股沟穿支皮瓣修复四肢皮肤软组织缺损的临床疗效。方法对29例伴有深部组织外露或骨缺损的四肢皮肤软组织缺损病例,采用髂腹股沟穿支皮瓣进行移植修复,其中采用旋髂浅动脉穿支皮瓣修复8例;采用旋髂深动脉穿支皮瓣修复4例;采用腹壁浅动脉穿支皮瓣修复8例;采用旋髂深动脉嵌合髂骨穿支皮瓣修复3例;采用髂腹股沟联体穿支皮瓣修复6例。皮瓣最小面积5.0 cm×6.0 cm,最大面积35.0 cm×15.0 cm。皮瓣供区均直接缝合。结果术后移植皮瓣全部成活,2例发生皮瓣皮下血肿压迫出现动脉供血障碍,拆除部分缝线后血运恢复,1例发生静脉血管危象,经手术探查后恢复血运。22例获得随访,随访时间为1~24个月,平均5个月。皮瓣质地柔软,外观较平坦,两点分辨觉10.0~20.0 mm。受区移植髂骨均生长良好,骨折完全愈合。供区见2例瘢痕稍增生,余均呈线状瘢痕愈合良好。结论移植髂腹股沟穿支皮瓣具有供区隐蔽,可直接缝合,不损伤主干动脉等传统优点,且具有可灵活修复骨缺损,可切取大面积联体(嵌合)穿支皮瓣及可修薄等特点,是修复四肢软组织缺损较为理想的方法。
[Abstract]:Objective to summarize the clinical effect of ilioinguinal perforating branch flap for repairing skin and soft tissue defect of extremities. Methods 29 cases of skin and soft tissue defect of extremities with deep tissue exposure or bone defect were reviewed. Ilioinguinal perforating branch flap was used in 8 cases, deep circumflex iliac artery perforating branch flap in 4 cases, perforating branch flap of superficial abdominal artery in 8 cases, perforating branch flap of superficial abdominal artery in 8 cases, perforating branch flap of deep circumflex iliac artery in 4 cases, perforating branch flap of superficial abdominal artery in 8 cases. Three cases were repaired with deep circumflex iliac artery chimerism and iliac perforating branch flap. Six cases were repaired with ilioinguinal combined perforating branch flap. The minimum area of flap was 5.0 cm 脳 6.0 cm, and the maximum area was 35.0 cm 脳 15.0 cm. The donor area of the flap was sutured directly. Venous vessel crisis occurred in 1 case after removal of partial suture, and followed up in 22 cases after surgical exploration. The follow up time was 1 ~ 24 months (mean 5 months). The skin flap was soft and flattened. The grafted iliac bone grew well and the fracture healed completely in the recipient area. Two cases of scar hyperplasia were seen in the donor area, and the others were all well healed. Conclusion the graft ilioinguinal perforator flap has hidden donor area and can be sutured directly. It is an ideal method to repair soft tissue defects of limbs because of its advantages such as no injury of main artery, flexible repair of bone defect, large area conjoined perforating flap and thinning.
【作者单位】：广州新江南手外科医院;
【基金】：广州市医药卫生科技项目(20161A010106)
【分类号】：R658

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