股前外侧皮瓣游离移植修复四肢远端软组织缺损

目的总结回顾我院运用股前外侧皮瓣的临床体会,探讨股前外侧皮瓣游离移植修复四肢远端软组织缺损的临床效果。方法分析2000年以来,选用股前外侧皮瓣游离移植修复皮肤软组织缺损并获随访3个月以上的病人48例（48块皮瓣）。软组织缺损面积12cm×5cm～26cm×16cm,皮瓣面积13cm×6cm～27cm×17cm。术后随访3～48个月,对皮瓣的外形、血液循环和感觉进行观测。结果本组48块皮瓣,完全成活47例;1例边缘部分坏死,经换药愈合;吻合股外侧皮神经36例,其中30例恢复保护性感觉,未吻合皮神经12例中4例恢复保护性感觉,2例手部皮瓣出现烫伤后溃疡经换药后疤痕愈合。吻合皮神经组与未吻合皮神经组相比较,保护性感觉的恢复率差异有统计学意义（P〈0.05）。结论吻合股外侧皮神经的股前外侧皮瓣游离移植是修复四肢远端软组织缺损较为理想的术式。

Free transplantation of anterolateral thigh skin flap for repairing of soft tissue defects in distal part of extremities

Objective To explore the clinical effect of free transplantation of anterolateral thigh skin flap for repairing of soft tissue defects in the distal part of extremities.Methods 48 cases with soft tissue defects in the distal part of extremities were treated by transplantation of free anterolateral femoral skin flaps since 2000.The patients aged from 17 to 55 years old with 39 male and 9 female.The area of soft tissue defects ranged from 12 cm×5 cm to 26 cm×16 cm,skin flaps 13 cm×6cm to 27 cm×l7 cm in size.All the cases were followed up postoperatively from 3 months to 48 months,The shape、circulation and the restoration of sensation of the flaps were observed and studied.Results 47 flaps survived perfectly,1 flaps survived with partial necrosis and healed after changing dressings.Out of 36 cases sutured with a cutaneous nerve,30 were satisfactory.4 cases got the similar results in 12 cases without cutaneous nerve anastomosis.Conclusion Free transplantation of anterolateral femoral skin flap companied with the anastomosis of the lateral femoral cutaneous nerve and is relatively an ideal operative type for the repair of soft tissue defects in the distal part of extremities.