摘要目的 探讨应用游离修薄股前外侧穿支皮瓣修复前臂、手、足部创面的临床疗效.方法 先确定皮瓣穿支血管部位,以此为中心,设计皮瓣并切取,保留阔筋膜盘约4.0 cm × 3.0 cm～3.0 cm×2.5 cm:"沙丘样"削除阔筋膜、皮下脂肪,皮瓣四周可将皮下脂肪完全削去,仅保留真皮层.采用游离修薄股前外侧穿支皮瓣修复前臂、手、足部创伤性软组织缺损15例.结果 全部病例术后无血管危象发生,有1例修复前臂创面皮瓣远端约2.0 cm×1.2 cm浅表坏死,经换药愈合.15例术后经3个月～2年随访,皮瓣外形、质地良好,两点辨别觉为8.0～10.0 mm.结论 游离修薄股前外侧穿支皮瓣外形、质地优良,受区感觉恢复良好,对供区创伤小,不需二期整形,是修复手、足部创面优良供区.

abstractsObjective To explore clinical effect of repairing soft tissue defect in forearm, hand and foot with free super-thin anterolateral thigh perforator flaps. Methods At first the site of perforator vessels were determined by Doppler, then the flaps were designed and harvested with the site as center; the fascia lata and subcutaneous fat were removed by sandhill-likely only the 4.0 cm × 3.0 cm - 3.0 cm×2.5 cm disc-like fascia lata and dermis layer were reserved. 15 traumatic soft tissue defects including forearm, hand and foot were repaired with the ree super-thin antemlateral thigh perforator flaps. Results No vascular crisis happened and all skin grafts survived in donor sites. 2.0 cm×1.2 cm of the distal of flap was necrosis in 1 case and it was healed by dress changing. 15 cases were followed up 3 months-2 years and the average is 6 months. The contour and texture of all flaps were good and two point discrimination (2-PD) was about 8-10 mm of. Conclusions The contour and texture of free super-thin anterolateral thigh perforator flap are good, the feeling of recipient site recovered well, it's less injury for donor site and there is no reshaping for flap. It is a fineness donor site for repairing soft tissue defects in hand and foot.