血流桥接股前外侧穿支皮瓣修复伴有血供障碍手掌皮肤软组织缺损

目的　探讨血流桥接股前外侧穿支皮瓣修复伴有血供障碍的手掌皮肤软组织缺损的方法及疗效。 方法　对9例伴有动脉血供障碍的手掌皮肤软组织缺损，应用旋股外侧动脉降支及其分支桥接手部缺损动脉，重建手部血供；旋股外侧动脉发出的穿支（肌间隙穿支或肌皮穿支）为皮瓣血供设计股前外侧皮瓣修复手皮肤软组织缺损。切取旋股外侧动脉降支及其分支长度为4~8 cm，切取皮瓣面积为7cm×9cm~11cm×16 cm。 结果 9例皮瓣全部成活，手部血供良好，供区植皮成活，术后3~9个月随访，皮瓣及手部末梢血供良好，皮瓣恢复保护性感觉，有排汗功能，部分供区有瘢痕增生。 结论　对伴有动脉血供障碍的手掌皮肤软组织缺损应用血流桥接股前外侧穿支皮瓣进行修复，，既可桥接血管，又可覆盖创面，是目前修复伴有动脉血供障碍的手掌皮肤软组织缺损一种较理想方法。

Flow-through anterolateral thigh perforator flap for the treatment of skin and soft tissue defects of palm with circulatory disorder

Objective　To investigate the application and clinical effects of flow-through anterolateral thigh perforator flap for the treatment of skin and soft tissue defects of palm with circulatory disorder. Methods　Anterolateral thigh perforator flap was used to repair skin and soft tissue defects of palm with arterial circulatory disorder in 9 cases. The injured artery was bridged by descending branch of lateral circumflex femoral artery for blood supply reestablishment. The flap was designed based on the perforating artery of lateral circumflex femoral artery (intermuscular branch or cutaneous branch). The length of descending branch of lateral circumflex femoral artery was from 4cm to 8cm, and the area of the flap was from 7 cm×9 cm to 11 cm×16 cm.　Results　All flaps and skin grafts of donor sites survived, and the repaired hands had good blood supply. All patients were followed up for 6 to 9 months．The flap and hand tip both had good blood supply. Protective sensation of the flap as well as sweating function was recovered. Scar formation occurred in some donor sites.　Conclusion　It may be an ideal method to use flow-through anterolateral thigh perforator flap for the treatment of skin and soft tissue defects of palm with arterial circulatory disorder. It can bridge the vessel and cover the wound.