股前外侧游离皮瓣修复足背烧伤后疤痕挛缩

目的探讨股前外侧游离皮瓣移植修复足背烧伤后疤痕挛缩的方法和临床效果。方法 应用股前外侧游离皮瓣移植修复足背烧伤后疤痕25例,将旋股外侧动脉降支及其伴行静脉分别与胫前动静脉吻合,并将股外侧皮神经与腓浅神经吻合,使皮瓣具有感觉功能。结果 25例患者移植皮瓣全部成活,创面一期愈合,经3个月至2年的随访,皮瓣感觉恢复达s3～s4,两点分辨觉为8～12mm,足背皮肤外观和质地良好。结论 股前外侧游离皮瓣供区隐蔽,血供丰富,可切取范围大,特别是带有感觉神经耐磨,是修复足背烧伤后疤痕的理想皮瓣。

Repairing burn scar contracture in dorsum of the foot by consecutive free anterolateral thigh flaps

Objective To explore the surgical technique and results of repairing burn scar contracture in dorsum of the foot by consecutive free anterolateral thigh flaps.Methods Twenty-five consecutive free anterolateral thigh flaps in 21 patients were transplanted for repairing burn scar contracture in dorsum of the foot from October 2004 to March 2009,suturing the descending branch of the lateral circumflex femoral vascular and anterior tibial vascular to reconstruct the blood supply of transplanted flaps,repairing superficial peroneal nerve to recover their sensation.Results All flaps survived completely,the wounds healed in the initial treatment.Following up 3 to 24 months,nine cases achieved partial sensation and good contour.Sensory recovery reached s3 to s4.Two-point discrimination was 8 to 12 mm.Conclusions The anterolateral thigh flap is an ideal flap for repairing burn scar contracture in dorsum of the foot,because it has such advantages as adequate blood supply,big dermatomic area and covert donor site,and nervi cutaneus femoris lateralis offers the good sensation.