桥式交叉吻合血管游离皮瓣移植方法改进与临床应用

目的：总结桥式交叉血管吻合游离皮瓣移手术方法改进与临床应用结果。方法：应用改进的桥式交叉血管吻合游离背阔肌皮瓣或穿支皮瓣移植方法修复8例（男6,女2）小腿软组织缺损。患者年龄20～49岁（平均33岁）,软组织缺损范围9cm×20cm～11cm×32cm。血管蒂行中厚网状游离植皮修复。结果：术后皮瓣全瓣成活,随访6月～4年（平均2.7年）,没有发现明显的供区功能障碍。健侧小腿经临床观察与Doppler检查,胫后动脉通畅,取得了较满意的效果。结论：改进的手术方法具有血管解剖恒定,血管蒂长以及血管吻合操作容易等优点,不损伤健侧小腿胫后动脉,降低了对供区的损伤。

Method improvement and clinical application of the cross-bridge vascular anastomosis free flap transplantation

Objective： To summarize the surgical method improvement and clinical application of the cross-bridge vascular anastomosis free flap transplantation. Methods： Eight patients（ 6 males,2 females） with soft tissue defect of the leg underwent the reconstruction with improved cross-bridge vascular anastomosis free latissmus dorsi muscle and perforator flaps transplantation. They ranged in age from 20 to 49 years （ mean 33 year） . Soft tissue defect ranged from 9 cm × 20 cm to 11 cm × 32 cm. Immediate coverage of the vascular pedicle was performed by a meshed split-thickness skin graft. Results： All patients were followed up for 6 months to 4 years （ mean 2. 8 year） . The flaps were completely survived without major complication,and there was no remarkable donor site mor- bidity. The patency of the posterior tibial artery of noninjured leg was satisfactory through clinical and Doppler examination. Conclusion： The improved method has constant vascular anastomy and a long vascular pedicle,so that vascular anastomosis can be easily accomplished. The patency of the posterior tibial artery of noninjured leg is preserved and the injury to donor site is reduced.