不带深筋膜的股前外侧穿支皮瓣的骨科临床应用.pdfVIP

不带深筋膜的股前外侧穿支皮瓣的骨科临床应用 朱跃良 李军 陈玉兵 徐永清 成都军区昆明总医院全军骨科中心 [摘要] 目的: 探讨不带深筋膜的股前外侧穿支皮瓣的切取要点及临床疗效。 方法: 2008-2009 年，切取股前外侧穿支皮瓣修复四肢创面 12 例，切取时保留绝大 部分深筋膜于原位，在穿支蒂部切取直径≤1cm 直径的深筋膜。结果： 股前外侧 肌间隔穿支 2 例，肌间穿支 8 例，高位皮穿支 2 例，均顺利切取，手术时间平均 为 4 小时皮瓣全部存活。不带深筋膜的股前外侧穿支皮瓣要略薄于带深筋膜的股 前外侧穿支皮瓣，切取难度略大，适用于污染不重或需要更薄覆盖的创面。结论： 不带深筋膜的股前外侧穿支皮瓣可以进一步减少供区损伤，临床应用安全有效。 【关键词】穿支皮瓣；切取；【文献标识码】 【文章编号】 Orthopedic Application of the anterolateral Femoral Perforator Flap without the Deep Fascia Zhu Yueliang, Li Jun, Chen Yubing, Xu Yongqing. Department of Orthopaedic Surgery, Kunming General Hospital, Chengdu Military Region, Kunming 650032, China Corresponding author: Xu Yongqin. ,Email：xuyongqingkm@ [Abstract] Objective: To explore the surgery tips of the anterolateral femoral perforator flap without the deep fascia and evaluate its clinic outcomes. Methods: From 2008-2009, 12 cases with soft tissue defects of the limbs were treated with the anterofemoral femoral perforator flap. Only the deep fascia in the pedicle within the diameter of 1 cm were taken while most of them were left in situ. Results: Of the 12 cases, there were 2 cases of intermuscular septum perforator, 8 case of intramuscular perforator , and 2 cases of high site direct perforator. The harvest of the flaps were uneventfully with an average surgery time of 4 hours. Compared with the anteorlateral femoral perforator flaps with the deep fascia, those without the deep fascia were thinner, more technical demanding, and suitable for the wounds with no serious infection or requiring thinner coverage. Conclusions: The anterolateral femoral perforator flap without the deep fascia could further decrease the donor site morbidity and it