游离皮瓣、肌皮瓣修复四肢软组织缺损

目的探讨四肢软组织缺损的修复.方法1.受区彻底清创,并解剖出拟吻合的受区血管.2.合并骨折者先安装外固定架,再依软组织缺损面积切取皮瓣或肌皮瓣.3.皮瓣或肌皮瓣移至受区,移植组织血管与受区血管端-端或端-侧吻合.结果应用该方法共修复75例,21例采用腹直肌皮瓣,8例背阔肌皮瓣,33例胸脐皮瓣,13例足背复合组织皮瓣.皮瓣全部成活,效果良好.结论1胸脐皮瓣、腹直肌皮瓣和背阔肌皮瓣血管蒂恒定,可切取面积大,是修复下肢软组织缺损的较好皮瓣.2.足背复合组织皮瓣是修复手背复合组织缺损的理想供区.

Free Flap or Musculocutaneous Flap Reconstruction for Soft-tissue Defects in Extremities

Objective: To provide a restoring way of soft-tissue defect in extremities. Methods: To dissect the receptor vessel for use after debridement of recipient wound. Depending on the size of soft-tissue defect of recipient wound, the flap or musculocutaneous flap were harvested after installing external fixator for fracture. The flap or musculocutaneous flap vessels were anastomosed in end to end or end to side fashion with the recipient vessels after the free flap or musculocutaneous flap were transferred to the recipient site. Results: Using this method, we treated 75 patients. Among them, 21 cases by rectus abdominis flap, 8 by muscular latissimus dorsi flap, 33 by thoraco-umbilical flap, 13 by dorsalis pedis flap. All were uneventful postoperation and had nothing noneffective. Conclusion: The thoraco-umbilical flap, muscular latissimus dorsi or rectus abdominis flap might be a better choice for a large soft-tissue defect in the lower limbs because of its constant vascular pedicle and large skin paddle. The free dorsalis pedis flap was an ideal flap to reconstruct composite defects in the dorsal hand.