下肢严重软组织缺损的游离皮瓣修复

目的：探讨游离皮瓣修复下肢严重软组织缺损的治疗效果。方法：自2006-01～2008—12，我科应用背阔肌皮瓣、股前外侧皮瓣、肩胛皮瓣、足背皮瓣、腓骨骨皮瓣对36例严重下肢软组织缺损的病例进行修复。结果：术后34例完全存活，2例股前外侧皮瓣远端部分坏死2～3cm，给予清除坏死部分的皮瓣组织后植皮，伤口愈合；随访3个月～3年，皮瓣质地良好，下肢功能改善和最大限度保留。结论：游离皮瓣修复下肢严重软组织缺损，根据损伤部位、范围、伤情选择不同的游离皮瓣进行修复效果可靠。

Repair of severe soft tissue defects of lower extremities with free flap

Objective： To investigate the effect of free flap on repairing severe soft tissue defects of lower extremities. Methods： From Jan. 2006 to Dec. 2008, latissimus dorsi flap, anterolateral thigh flap, scapular flap, pedal dorsal flap and fibular flap were used to repair severe soft tissue defects of lower extremities in 36 patients. Results：A total of 34 flaps survived well, and necrosis zone （2 to 3 em） was observed at the distal part of anterolateral thigh flaps in 2 patients. After removing the necrosis part of the flap and repairing the residual wounds with skin graft, the function and profile of the lower extremities were improved and reserved maximatily during the followup period （range, 3 months to 3 years）. Conclusion：Free flaps is dependable for repairing severe soft tissue defects of lower extremities, different kinds of flaps could be used according to the site, size and severity of the wound.