摘要目的 探讨不同形式股前外侧皮瓣在小腿踝关节离断合并大面积皮肤软组织缺损修复的应用.方法 自2011年9月至2015年12月,应用不同形式股前外侧皮瓣游离移植修复外伤所致小腿踝关节离断伤合并大面积皮肤软组织缺损26例,男20例,女6例.年龄22 ～61(38.6±4.5)岁.其中10例为血流桥接股前外侧皮瓣,16例为股前外侧嵌合股外侧肌肌皮瓣,15例皮瓣完成一期修薄,5例皮瓣以双叶形式完成切取,皮瓣面积10cm×6 cm～28 cm×12 cm.所有皮瓣供区直接闭合.结果所有皮瓣及再植肢体均完全成活,术后经8～30个月随访,患足外观功能恢复满意,皮瓣质地好,外形不臃肿,无需二期修薄,无溃疡发生,恢复保护性感觉.供区仅遗留线性瘢痕,无肌疝发生.结论不同形式的股前外侧皮瓣是小腿踝关节不全离断合并大面积皮肤软组织缺损修复的有效选择.

abstractsObjective To explore the application of various forms of anterolateral thigh flap in lower extremity and ankle amputation with extensive skin and soft tissue defect reconstruction.Methods From September 2011 to December 2015,26 cases of lower extremity and ankle amputation with extensive skin and soft tissue defect reconstruction (included 20 male patients and 6 female patients) were admitted,the age ranged from 22 to 61 years old (38.6 ± 4.5).Among these cases,10 cases received flow-through anterolateral thigh flap,16 cases used chimeric anterolateral thigh flap with vastus lateralis thigh muscle flap,15 flaps were thinned in one-staged,5 flaps were harvested in double-paddled form.The flap size ranged from 10 cm × 6 cm to 28 cm × 12 cm.The donor site was closed directly in all cases.Results All flaps and replanted extremities survived uneventfully.All patients were followed up for 8 to 30 months with satisfied esthetic and functional results in reconstructed foot and ankle,the texture of flaps was good,no bulky was noted and no second revision was needed.No local ulcer happened and regained protective sensation.Only linear scar left in the donor sites,no hernia occurred.Conclusions Various forms of anterolateral thigh flap is the effective choice in lower extremity and ankle amputation with extensive skin and soft tissue defect reconstruction.