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不同动脉吻合方式的游离旋髂浅动脉穿支皮瓣移植修复四肢皮肤软组织缺损
引用本文:田敏涛,李苗钟,胡浩良,方炫量,李一,李学渊.不同动脉吻合方式的游离旋髂浅动脉穿支皮瓣移植修复四肢皮肤软组织缺损[J].中华创伤杂志,2022(2):149-154.
作者姓名:田敏涛  李苗钟  胡浩良  方炫量  李一  李学渊
作者单位:宁波市第六医院手外科
摘    要:目的:探讨不同动脉吻合方式的游离旋髂浅动脉穿支皮瓣移植修复四肢皮肤软组织缺损的临床疗效。方法:采用回顾性队列研究分析2017年3月至2020年3月宁波市第六医院收治的60例四肢皮肤软组织缺损患者临床资料,其中男38例,女22例;年龄21~57岁[(35.6±3.1)岁]。缺损部位:上肢33例,下肢27例。缺损面积为4....

关 键 词:四肢  软组织损伤  穿支皮瓣  吻合

Free superficial iliac circumflex artery perforator flap with different arterial anastomosis methods for repairing soft tissue defects of limbs
Tian Mintao,Li Miaozhong,Hu Haoliang,Fang Xuanliang,Li Yi,Li Xueyuan.Free superficial iliac circumflex artery perforator flap with different arterial anastomosis methods for repairing soft tissue defects of limbs[J].Chinese Journal of Traumatology,2022(2):149-154.
Authors:Tian Mintao  Li Miaozhong  Hu Haoliang  Fang Xuanliang  Li Yi  Li Xueyuan
Institution:(Department of Hand Surgery,Ningbo No.6 Hospital,Ningbo 315040,China)
Abstract:Objective To investigate the clinical effect of free superficial iliac circumflex artery perforator flap with different arterial anastomosis methods for repairing soft tissue defects of limbs.Methods A retrospective cohort study was used to analyze the data of 60 patients with soft tissue defects of limbs treated in Ningbo No.6 Hospital from March 2017 to March 2020,including 38 males and 22 females,aged 21-57 years(35.6±3.1)years].The wounds were located on the upper limb in 33 patients and the lower limb wound in 27 patients.The defect area was 4.5 cm×2.0 cm-17.0 cm×8.0 cm.All patients received debridement and vacuum sealing drainage(VSD)in stage I,and free superficial iliac circumflex artery perforator flap transplantation in stage II.The flap area was 4.9 cm×2.6 cm-17.0 cm×8.0 cm.According to the different anastomotic vessels,the superficial iliac circumflex artery was anastomosed end-to-side to the radial artery in 25 patients,the ulnar artery in 8,the dorsalis pedis artery in 18 and the anterior tibial artery in 9.Flap healing and healing time were detected.Texture and appearance of the flap were observed at the last follow-up.The appearance of the donor area was evaluated by Vancouver scar scale(VSS),and the satisfaction rate of appearance of the recipient area was measured by numerical score.Results All patients were followed up for 5-15 months(7.1±1.3)points].All flaps survived successfully after operation,including arterial crisis in 4 patients,among which 2 had flap perforator anastomosed with the radial artery,1 with the ulnar artery and 1 with the dorsalis pedis artery.There was no significant difference in flap crisis after end-to-side arterial anastomosis in different recipient areas(P>0.05).For patients with flap perforator anastomosed with the radial artery,the ulnar artery,the dorsalis pedis artery and the anterior tibial artery,the flap healing time was 15(14,16)days,15(14,16)days,14.5(14,16)days and 14(14,15.5)days,respectively(all P>0.05).The flaps showed sufficient elasticity and soft texture at the last follow-up.For patients with flap perforator anastomosed with the radial artery,the ulnar artery,the dorsalis pedis artery and the anterior tibial artery,the VSS of the donor area was(10.2±1.5)points,(10.9±1.6)points,(9.4±1.5)points and(9.8±1.5)points at the last follow-up(all P>0.05),and the satisfaction rate of appearance of the recipient area was 9(8,10)points,9(8,9)points,9(8,9)points and 8(8,9.5)points at the last follow-up(P>0.05),showing that all patients were satisfied with the appearance of the wound.Conclusions The transplantation of free superficial iliac circumflex artery perforator flap with different arterial anastomosis methods is safe and reliable in repairing soft tissue defects of limbs with advantages of low occurrence of postoperative vascular crisis,good flap survival,no influence on flap healing by different anastomotic vessels,hidden donor area with small scar and satisfactory appearance of the recipient area.It can be used as one of the common vascular repair methods for free tissue flap transplantation.
Keywords:Extremities  Soft tissue injuries  Perforator flap  Anastomosis
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