不同方式的小腿外侧皮瓣修复严重肢体组织缺损(附23例报告)

目的探讨应用不同方式的小腿外侧皮瓣修复严重肢体组织缺损的治疗方法。方法对23例严重肢体组织缺损的患者,根据不同部位、程度及缺损面积大小,分别选择应用不同方式的小腿外侧皮瓣移植技术进行修复,即吻合血管的游离皮瓣移植术、带血管蒂的岛状皮瓣转位移植术和带血管蒂的交腿皮瓣移植术。结果23例皮瓣完全成活,2例出现了循环危象,经积极治疗后缓解,皮瓣边缘表皮部分坏死。术后随访6个月~4年,部分病例恢复了保护性感觉。19例患者对肢体功能和外形均表示满意,4例表示能接受。结论应用三种不同方式的小腿外侧皮瓣修复严重肢体组织缺损是一种简单、安全、有效的治疗方法,可以大大减少了肢体的截肢率和并发症,是治疗严重肢体组织缺损的一种理想方法。

Different Methods of Ectocnemial Compound Flap in Repair of Severe Tissue Defects of Extremity

Objective To investigate different methods of ectocnemial compound flap in repair of severe tissue defects of extremity.Methods According to the size and position of recipient region of limbs, and distance between recipient site and donor site as well as the patient's will, different methods of ectocnemial compound flap were used for limbs coverage and tissue reconstruction in 23 patients comprising free ectocnemial compound flap by vessels anastomosis, transplantation of the vascularized pedicle isle ectocnemial compound flap and ectocnemial compound flap from the other leg.Results All patients were followed up for 6 months to 4 years. The composite flap survived completely in 23 patients.Insufficient arterial supply of the flap occurred in 2 patients after operation. Necrosis occurred partly in distal part of skin.The flap ischemia was released. The color and texture of the flap were excellent. The part protective sensation was recovered. The configuration and function were satisfactory.Conclusion The application of different methods of ectocnemial skin flap in repair of severe tissue defects of extremity is safe, simple, reliable and effective alternative for limbs coverage and tissue reconstruction.Effective method can improve successful rates,and significantly reduce the deformity rates and complications of limbs with severe soft tissue defects.It is one of the optimal compound flap to reconstruct severe tissue defects.