Repair of complex wounds of limbs with free lobed perforator flaps_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Hai , XIAO Shun’e , DENG Chengliang , WU Bihua , ZHANG Tianhua , LIU Zhiyuan , NIE Kaiyu ,  WEI Zairong

Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China;

Corresponding?author：

WEI Zairong, Email: zairongwei@sina.com

Keywords：

Free lobed perforator flap; limb; soft tissue defect; wound repair

DOI：

10.7507/1002-1892.202108084

Video：

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Objective To explore the effectiveness of free lobed perforator flaps in repairing of complex wounds of limbs. Methods Between January 2018 and January 2021, 10 patients with complex wounds of limbs were admitted. There were 7 males and 3 females, aged from 32 to 64 years, with an average age of 45 years. There were 4 cases of traffic accident injuries, 3 cases of machine strangulation injuries, 1 case of machine crush injury, and 2 cases of heavy object crush injuries. There were 5 cases of upper limb wounds and 5 cases of lower limb wounds. The size of wounds ranged from 11 cm×10 cm to 25 cm×18 cm. The wounds were repaired with tri-lobed flaps of the descending branch of the lateral femoral circumflex artery in 7 cases, four-lobed flaps in 2 cases, and with tri-lobed flaps of the descending branch of the lateral femoral circumflex artery combined with oblique branch in 1 case. The size of flaps ranged from 12.0 cm×10.5 cm to 28.0 cm×12.0 cm. The donor sites were sutured directly in 9 cases and repaired with superficial iliac circumflex artery perforator flap in 1 case. Results Sinus formed at the edge of the flap in 1 patient, which healed after dressing change and drainage; other flaps survived well, and the wounds healed by first intention. The skin flap at donor site survived, and the incisions healed by first intention. All patients were followed up 6-24 months (mean, 11 months). All flaps had good appearance and function, and linear scars were left at the donor site without obvious complications. Conclusion Free lobed perforator flap is an alternative method to repair complex wounds of limbs with high safety, good effectiveness, and less complications.

Citation： LI Hai, XIAO Shun’e, DENG Chengliang, WU Bihua, ZHANG Tianhua, LIU Zhiyuan, NIE Kaiyu, WEI Zairong. Repair of complex wounds of limbs with free lobed perforator flaps. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(1): 98-101. doi: 10.7507/1002-1892.202108084 Copy

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9.	常樹森, 金文虎, 魏在榮, 等. 股前外側皮瓣術前設計優化及臨床應用. 中華顯微外科雜志, 2017, 40(2): 118-122.
10.	牟勇, 黎路根, 胡春蘭, 等. 削薄分葉股前外側穿支皮瓣修復四肢復雜軟組織缺損. 中華顯微外科雜志, 2019, 42(3): 218-222.
11.	古欣慶, 周洋, 朱紅亮, 等. 削薄股前外側皮瓣在兒童足踝部軟組織缺損中的應用. 實用手外科雜志, 2021, 35(2): 173-176.
12.	葉琪毅, 張文廣, 唐亞飛, 等. 削薄股前外側穿支皮瓣修復足踝部較大面積軟組織缺損. 中華顯微外科雜志, 2020, 43(6): 544-548.

1. 朱雄翔, 鄭朝, 張冬梅, 等. 擴張穿支皮瓣游離移植治療兒童嚴重瘢痕攣縮畸形的效果. 中華燒傷雜志, 2019, 35(6): 405-409.
2. Jia YC, Chen HH, Kang QL, et al. Combined anterolateral thigh and anteromedial thigh flap for extensive extremity reconstruction: vascular anatomy and clinical application. J Reconstr Microsurg, 2015, 31(9): 674-680.
3. 張偉, 謝衛國, 楊飛, 等. 游離股前外側穿支皮瓣分葉移植在四肢電燒傷治療中的臨床應用. 中華燒傷雜志, 2019, 35(11): 790-797.
4. 邢長泰, 吳錦生, 馬俊偉, 等. 游離旋股外側動脈降支穿支皮瓣修復前臂大面積皮膚缺損. 中國美容整形外科雜志, 2020, 31(7): 421-424.
5. 李海, 魏在榮, 張文奪, 等. 多穿支旋股外側動脈穿支皮瓣在兒童四肢復雜創面中的應用. 中華顯微外科雜志, 2017, 40(5): 428-432.
6. 常樹森, 魏在榮, 金文虎, 等. 股前外側皮瓣三縱五橫法設計方案的臨床研究. 中華整形外科雜志, 2019, 35(6): 571-576.
7. 王明智, 鄭鈞水, 陳薇薇, 等. 肌皮瓣聯合骨水泥治療Cierny-Mader Ⅲ~Ⅳ型骨髓炎的療效. 中華顯微外科雜志, 2021, 44(1): 29-35.
8. 黃雄杰, 謝松林, 劉昌雄, 等. 股深動脈第3穿支穿支皮瓣Ⅰ期修復Pilon骨折術后軟組織缺損. 中華顯微外科雜志, 2021, 44(3): 287-291.
9. 常樹森, 金文虎, 魏在榮, 等. 股前外側皮瓣術前設計優化及臨床應用. 中華顯微外科雜志, 2017, 40(2): 118-122.
10. 牟勇, 黎路根, 胡春蘭, 等. 削薄分葉股前外側穿支皮瓣修復四肢復雜軟組織缺損. 中華顯微外科雜志, 2019, 42(3): 218-222.
11. 古欣慶, 周洋, 朱紅亮, 等. 削薄股前外側皮瓣在兒童足踝部軟組織缺損中的應用. 實用手外科雜志, 2021, 35(2): 173-176.
12. 葉琪毅, 張文廣, 唐亞飛, 等. 削薄股前外側穿支皮瓣修復足踝部較大面積軟組織缺損. 中華顯微外科雜志, 2020, 43(6): 544-548.

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Chinese Journal of Reparative and Reconstructive Surgery

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