摘要目的 探讨临床应用股前外侧皮瓣的供区并发症及其治疗措施.方法 回顾性总结1988年7月至2007年7月,有效随访的427例施行股前外侧皮瓣手术供区的处理方法.其中:①直接缝合:单纯皮瓣49例,筋膜瓣27例;②游离植皮:单纯皮瓣258例;肌皮瓣65例;③逆行腹壁浅动脉皮瓣:28例.皮瓣或筋膜瓣切取面积30 cm×10 cm～18 cm×7 cm.随访时间8～54个月,平均21个月.采用SPSS 11.0.1对供区并发症进行统计学分析.结果 近期并发症(4周内)包括:植皮区皮肤坏死23例(5.4%),伤口感染17例(4.0%),肌肉坏死2例(0.5%);远期的并发症(6个月以上)包括:伤口迁延不愈21例(4.9%),严重瘢痕28例(6.6%),严重局部不适感25例(5.9%),股四头肌功能障碍16例(3.7%).统计分析表明供区手术方式与供区并发症的出现具有相关性,部分并发症之间存在相互影响.结论 应重视股前外侧皮瓣供区并发症的防治,合理选择和改良供区手术方案.术中注意软组织保护等均可有效预防和降低术后并发症的发生.供区采用股前外侧筋膜瓣移植或局部皮瓣转移修复供区是理想的选择.

abstractsObjective To discuss the donor site complications and the treatments of the anterolateral thiIgh flap transfer. Methods From July 1988 to July 2007,427 patients treated by anterolateral thish flap surgery were followed up.The donor sites were treated by several methods,including direct closure(49 cases),skin graft transfer(258 cases),anterolateral fascial flap transfer(27 cases),musculocutaneous flap and skin sraft transfer(65 cases), superficial epigastric artery flap transfer(28cases).The area of these flaps ranged from 30 cm×10 cm to 18 cm×7 cm.and the average follow-up was 21 months(ranged from 8 months to 54 months). All the data was analyzed by SPSS for Windows,Version 11.0.1. Results Short-term complications(within 4 weeks)and long-term complications (over 6months)were observed.The former included skin necrosis(5.4%),wound infection(4.0%),and necrosis of rectus femoris(0.5%); and the latter included chronic ulcer(4.9%), aerious scar(6.6%), serious discomfortable(5.9%),and quadriceps femoris disfunction(3.7%).The statistical results showed that there was a close correlation between the donor site morbidity and the surgical methods. Conclusion The complications of the donor site cannot be ignored.Protect the soft-tissue of the donor site carefully,design all appropriate operation plan.Careful preoperative examination and local flap transplantation can effectively decrease the rate of complications.