MEDLINE/PubMed Journal Browser Search

Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

Title: [Clinical effects of individualized free anterolateral thigh flap in repairing complex refractory wound].
Author: Yang L, Cai B, Xue JR, Jiang P, Guo XZ.
Journal: Zhonghua Shao Shang Za Zhi; 2020 Aug 20; 36(8):730-734. PubMed ID: 32829614.
Abstract:
Objective: To explore the clinical effects of individualized free anterolateral thigh flap in repairing complex refractory wound. Methods: From July 2015 to May 2019, 19 patients with complex refractory wounds were hospitalized in Yulin NO.1 People's Hospital of Guangxi Zhuang Autonomous Region, including 12 males and 7 female, aged 13-67 years. There were 5 patients with multiple tissue defects, 7 patients with large area of wounds, and 7 patients with wounds in special areas. The sizes of wounds after complete debridement were 8 cm×5 cm-23 cm×7 cm. According to the repair demand, the wounds in 5 patients were repaired with anterolateral thigh flaps and flow-through, the wounds in 7 patients were repaired with anterolateral thigh flaps chimed with lateral thigh muscle flaps, with vascular anastomosis in 2 patients, the wounds in 6 patients were repaired with unilateral anterolateral thigh lobulated flaps, and the wound in 1 patient was repaired with bilateral anterolateral thigh flap in series connection. The sizes of flaps were 10 cm×7 cm-25 cm×9 cm. The donor sites were sutured directly or repaired with thin split-thickness skin graft of head. The survival of the flaps, the appearance of the donor sites, and wounds repair after the operation and during follow-up were observed. Results: The lobulated flap in 1 patient had local necrosis after the operation and finally healed by debridement, dressing change, and transplanting medium split-thickness skin graft in groin. The flaps in 18 patients survived with good blood supply, and the lobulated flap tissue was swollen in 1 of 18 patients. The donor sites which were directly sutured in 18 patients only had linear scar, and the donor site which was repaired with thin split-thickness skin graft of head in 1 patient had flaky scar. Follow-up of 1-12 months showed that all the wounds healed well, the flap thinning operations were performed in 5 patients in 3 months post operation because the flaps were slightly bloated. The CT angiography after the operation showed that the anastomosed blood vessels were unobstructed in 7 patients with reconstructed local blood supply. Conclusions: The special forms of anterolateral thigh flap, such as lobulation, series connection, and chimerism can be designed according to the anatomical characteristics of the descending branch of the lateral femoral artery to meet individualized repair demand for complex refractory wounds, and achieve the double purposes of making full use of the donor site tissue and good repair of the recipient site. 目的： 探讨个体化股前外侧皮瓣游离移植修复复杂难愈性创面的临床效果。 方法： 广西壮族自治区玉林市第一人民医院2015年7月—2019年5月收治复杂难愈性创面患者19例，其中男12例、女7例，年龄13～67岁。5例患者存在多种组织结构缺损，7例患者创面面积大，7例患者创面位于特殊部位。彻底清创后创面面积8 cm×5 cm～23 cm×7 cm。根据修复的需要，选择股前外侧皮瓣联合血流桥接修复5例；股前外侧皮瓣嵌合股外侧肌肌瓣修复7例，其中2例行血管吻合；单侧股前外侧分叶皮瓣修复6例；双侧股前外侧串联皮瓣修复1例。皮瓣面积为10 cm×7 cm～25 cm×9 cm。供瓣区直接拉拢缝合或取头部刃厚皮修复。观察术后及随访时皮瓣成活情况、供区外观及创面修复情况。 结果： 术后1例患者分叶皮瓣出现部分坏死，经换药清创移植腹股沟中厚皮修复；18例患者皮瓣成活，血运良好，其中1例患者分叶皮瓣组织肿胀。18例供瓣区直接缝合患者，供瓣区仅遗留线状瘢痕；1例供瓣区取头部刃厚皮修复患者，供瓣区遗留片状瘢痕。术后随访1个月～1年，所有创面均愈合良好，5例患者由于皮瓣臃肿于术后3个月行修薄处理，7例重建局部血流的患者术后复查CT血管造影显示吻合血管通畅。 结论： 根据旋股外侧动脉降支解剖特点，可形成分叶、串联、嵌合等特殊股前外侧皮瓣，满足复杂难愈性创面修复的个体化需求，取得供区组织最大化利用及受区良好修复的双重效果。.

[Abstract] [Full Text] [Related] [New Search]