股上部直接皮动脉皮瓣在肢体组织缺损中的应用

目的探讨股上部直接皮动脉皮瓣修复肢体组织缺损的临床疗效。方法应用Doppler血流探测仪在腹股沟中点以下约4cm处确定股上部直接皮动脉血管发出点，该点向髂-髌连线中点外上方探测血流声最响处，为动脉穿出点。动脉发出点与穿出点连线为皮瓣轴线，切取皮瓣面积4cm×6cm-11cm×18cm，共修复46例皮肤软组织缺损。结果本组46例股上部直接皮动脉皮瓣，除3例皮瓣边缘部分坏死外，其余皮瓣全部成活，术后随访2-21个月，平均14．1月。皮瓣外形满意，质地柔软，感觉恢复良好。结论该皮瓣不携带肌肉，切取容易，可携带股前外侧皮神经，同时修复缺损部位感觉，是肢体组织缺损修复较为理想的选择。

Direct cutaneous artery skin flap of superior thigh for coverage of soft tissue defect

Objective To study the clinical outcome of the direct cutaneous artery skin flap of superior thigh for soft tissue coverage. Methods About 4 cm bellow the midpoint of the ingninal ligament, the original point of direct cutaneous artery of superior thigh was located by ultrasound Doppler. From this point to the superior-laterally side of the midpoint of the line between the anterior superior iliac spine and lateral margin of patella, the perforating point of cutaneous branch could be detected by Doppler. The line between these two point was regarded as the longitudinal axis of the direct cutaneous artery skin flap of superior thigh. From June 1999 to January 2007, the flaps was used in 46 cases. The area of the flap ranged from 4cm×6cm-11cm×18cm.Results Among the 46 cases of direct cutaneous artery skin flap of superior thigh,3 flaps survived with partical necrosis, the others survived perfectly. Average follow-up was 14.1 months, ranged from 2 to 21 months. The flaps had soft texture, good appearance and protective sensation. Conclusion The direct cutaneous artery skin flap of superior thigh could be operated easily and harvested without any muscle.The lateral femoral cutaneous nerve can be harvest and anastomosed with a cutaneous nerve of receptive site. The flap is a optimal choice for repair of soft tissue defect.