游离股前外侧皮瓣在复杂头皮软组织缺损中的应用

目的 探讨游离股前外侧皮瓣修复复杂头皮软组织缺损的临床疗效。方法 应用游离股前外侧皮瓣修复20例复杂头皮软组织缺损患者，其中合并颅骨外露6例，颅骨缺损3例，合并感染4例，合并头皮疤痕挛缩9例。头皮缺损面积6 cm×10 cm～22 cm×13 cm，颅骨外露6 cm×8 cm～21 cm×12 cm。结果 术后随访6个月～2年，19例皮瓣均完全成活，皮瓣柔软，无明显色素沉着。其中1例小儿患者术后第3天出现皮瓣远端颅顶部部分发黑，予以换药、温盐水热敷、蒂部缝线拆除后皮瓣成活，但遗留色素沉着。20例患者中，仅1例发生供区发生植皮边缘坏死，予以换药处理后创面愈合。结论 旋股外侧动脉降支与颞浅动脉口径相当，应用游离股前外侧皮瓣可有效修复创伤及肿瘤所致复杂头皮软组织缺损。

Anterolateral thigh flap in complex scalp defects

Objective To discuss the clinical efficacy of the free anterolateral thigh flap in complex scalp soft tissue defects. Methods Twenty patients with complex scalp defects were treated with the free anterolateral thigh flap. Six cases had skull exposure, 3 were complicated with skull defect, 4 with soft tissue infection, and 9 with scar contracture. The extent of defect ranged from 6 cm×10 cm to 22 cm×13 cm. The size of skull exposure was between 6 cm×8 cm to 21 cm×12 cm. The clinical efficacy after operation was observed. Results During a follow-up period of 6 months to 2 years, of 20 patients undergoing the free anterolateral thigh flap scalp repair, 19 cases achieved satisfactory outcome. The flaps were soft without significant dyspigmentation. One case had apical scaring and hyperpigmentation, possibly caused by prolonged ischemia on the edge of the flap. The flap survived after conservative treatment. Conclusion Complex scalp defects can be effectively treated with the free anterolateral thigh flap.