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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6.	常树森, 魏在荣, 金文虎, 等. 股前外侧皮瓣三纵五横法设计方案的临床研究. 中华整形外科杂志, 2019, 35(6): 571-576.
7.	王明智, 郑钧水, 陈薇薇, 等. 肌皮瓣联合骨水泥治疗Cierny-Mader Ⅲ~Ⅳ型骨髓炎的疗效. 中华显微外科杂志, 2021, 44(1): 29-35.
8.	黄雄杰, 谢松林, 刘昌雄, 等. 股深动脉第3穿支穿支皮瓣Ⅰ期修复Pilon骨折术后软组织缺损. 中华显微外科杂志, 2021, 44(3): 287-291.
9.	常树森, 金文虎, 魏在荣, 等. 股前外侧皮瓣术前设计优化及临床应用. 中华显微外科杂志, 2017, 40(2): 118-122.
10.	牟勇, 黎路根, 胡春兰, 等. 削薄分叶股前外侧穿支皮瓣修复四肢复杂软组织缺损. 中华显微外科杂志, 2019, 42(3): 218-222.
11.	古欣庆, 周洋, 朱红亮, 等. 削薄股前外侧皮瓣在儿童足踝部软组织缺损中的应用. 实用手外科杂志, 2021, 35(2): 173-176.
12.	叶琪毅, 张文广, 唐亚飞, 等. 削薄股前外侧穿支皮瓣修复足踝部较大面积软组织缺损. 中华显微外科杂志, 2020, 43(6): 544-548.

1. 朱雄翔, 郑朝, 张冬梅, 等. 扩张穿支皮瓣游离移植治疗儿童严重瘢痕挛缩畸形的效果. 中华烧伤杂志, 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. 张伟, 谢卫国, 杨飞, 等. 游离股前外侧穿支皮瓣分叶移植在四肢电烧伤治疗中的临床应用. 中华烧伤杂志, 2019, 35(11): 790-797.
4. 邢长泰, 吴锦生, 马俊伟, 等. 游离旋股外侧动脉降支穿支皮瓣修复前臂大面积皮肤缺损. 中国美容整形外科杂志, 2020, 31(7): 421-424.
5. 李海, 魏在荣, 张文夺, 等. 多穿支旋股外侧动脉穿支皮瓣在儿童四肢复杂创面中的应用. 中华显微外科杂志, 2017, 40(5): 428-432.
6. 常树森, 魏在荣, 金文虎, 等. 股前外侧皮瓣三纵五横法设计方案的临床研究. 中华整形外科杂志, 2019, 35(6): 571-576.
7. 王明智, 郑钧水, 陈薇薇, 等. 肌皮瓣联合骨水泥治疗Cierny-Mader Ⅲ~Ⅳ型骨髓炎的疗效. 中华显微外科杂志, 2021, 44(1): 29-35.
8. 黄雄杰, 谢松林, 刘昌雄, 等. 股深动脉第3穿支穿支皮瓣Ⅰ期修复Pilon骨折术后软组织缺损. 中华显微外科杂志, 2021, 44(3): 287-291.
9. 常树森, 金文虎, 魏在荣, 等. 股前外侧皮瓣术前设计优化及临床应用. 中华显微外科杂志, 2017, 40(2): 118-122.
10. 牟勇, 黎路根, 胡春兰, 等. 削薄分叶股前外侧穿支皮瓣修复四肢复杂软组织缺损. 中华显微外科杂志, 2019, 42(3): 218-222.
11. 古欣庆, 周洋, 朱红亮, 等. 削薄股前外侧皮瓣在儿童足踝部软组织缺损中的应用. 实用手外科杂志, 2021, 35(2): 173-176.
12. 叶琪毅, 张文广, 唐亚飞, 等. 削薄股前外侧穿支皮瓣修复足踝部较大面积软组织缺损. 中华显微外科杂志, 2020, 43(6): 544-548.

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Chinese Journal of Reparative and Reconstructive Surgery

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