应用带少许肌袖的背阔肌肌皮瓣修复下肢软组织缺损

目的探讨应用带少许肌袖的背阔肌肌皮瓣移植修复下肢软组织缺损的临床效果。方法2000年6月～2006年12月,应用带少许肌袖的背阔肌肌皮瓣移植修复8例下肢软组织缺损患者。男6例,女2例;年龄25～69岁。其中创面位于足跟3例,足背2例,胫前2例,右小腿鳞癌1例。软组织缺损范围10cm×7cm～18cm×12cm,皮瓣切取范围15cm×8cm～22cm×15cm。结果术后6例皮瓣成活;1例术后2h出现皮瓣血管危象,经探查重新吻合静脉,植皮后成活;1例胫前创面因骨髓炎感染,经引流后皮瓣成活。创面及供区均期愈合。8例患者获随访3～12个月。皮瓣外形满意,无臃肿。供区功能不受影响。结论应用带少许肌袖的背阔肌肌皮瓣移植是修复大面积肢体软组织缺损较为理想方法之一。

CLINICAL APPLICATION OF LATISSIMUS DORSI MUSCULOCUTANEOUS FLAP WITH A FEW MUSCLE IN REPAIRING SOFT TISSUE DEFECT OF LOWER LIMBS

OBJECTIVE: To explore the clinical effect of latissimus dorsi musculocutaneous flap with a few muscle in repairing the soft tissue defect of lower limbs. METHODS: From June 2000 to December 2006, 8 patients with soft tissue defects of lower limbs were repaired with the latissimus dorsi musculocutaneous flaps. There were 6 males and 2 females, aged from 25-69 years. The locations were heel in 3 cases, dorsum pedis in 2 cases, anticnemion in 2 cases, and the right leg (squamous carcinoma) in 1 case. The area of soft defect ranged from 10 cm x 7 cm - 18 cm x 12 cm. The flap in size ranged from 15 cm x 8 cm to 22 cm x 15 cm. RESULTS: Of all the flaps, 6 survived, 1 had vascular necrosis 2 hours after operation and survived by skin grafts, 1 had delayed healing because of infection. The wound and, donor site achieved primary healing. The follow-up for 3 to 12 months revealed that all the flaps had a good appearance. The function of donor site was as normal. CONCLUSION: It is an ideal method to repair the soft tissue defect of lower limbs with latissimus dorsi musculocutaneous flap.