摘要
目的 探讨肌肉锚定联合负压植皮修复股前外游离皮瓣供区继发创面临床效果。方法 选取笔者单位2020年1月-2021年1月 9例切除股前外侧游离皮瓣后供区无法直接拉拢缝合关闭创面患者，均为男性，皮瓣切取面积为14cm×9cm-24cm×18cm，皮瓣切取后供区无法直接拉拢缝合，将外露肌肉修整，以2-0吸收线内翻缝合形成平整创面，4-0可吸收线将皮缘真皮浅层、阔筋膜残端、肌肉锚着固定，让供区形成平整相对稳定创面，取刃厚皮移植其上，负压覆盖固定加压。结果 术后8例皮片全部一期存活未出现坏死，1例患者为硬皮病患者，皮片质量较差，术后皮片部分坏死，进行了二期植皮修复。术后2月随访，所有患者植皮区瘢痕平坦，行走无明显肌肉疝出，取瓣区肢体无功能障碍。结论 肌肉锚定联合负压植皮能够较传统供区植皮加压包扎方法更利于创面一期修复，供区愈合较平整，是修复股前外供区继发创面一个良好方法。
关键词： 游离股前外侧穿支皮瓣；供区；皮片移植；负压治疗
Abstract
Objective To investigate the clinical effect of muscle anchoring unite negative pressure and skin grafting in repairing secondary wounds in doner sites of free anterolateral femoral perforator pfaps. Methods From January 2020 to January 2021, 9 patients (all males, aged 16-68 years) were treated by free anterolateral femoral perforator flaps and the donor site could not be directly.Flap sizes ranged from 14cm×9cm-24cm×18cm,The donor site could not be directly due to various factors,First, the exteriorized muscle was trimmed . Then use varus sutures with 2-0 SB-ORB to make the wound flat，Anchoring the superficial dermis of wound margin and muscle by 4-0 SB-ORB, make the donor area form a flat and relatively stable wound . Last , thick skin grafts on the wound surface ,negative pressure material is covered, fixed and pressurized. Results After operation, 8 cases of skin graft survived and no necrosis , 1 casewas scleroderma ,the quality of skin graft was poor, and the skin graft was partly necrotic after operation，need to skin grafting secondary. All patients were followed up for 2 months after operation, the scar of skin graft area was flat, and no obvious muscle hernia during walking and dysfunction of the limbs. Conclusion s Muscle anchoring unite negative pressure and skin grafting can overcome some shortcomings of traditional skin grafting , more favorable for wound one-stage repair and donor site is flatter . Suitable for repairing secondary wounds in doner sites of free anterolateral femoral perforator pfaps.
Key words： Free anterolateral femoral perforator pfaps; Doner sites; Skin graft; Negative pressure therapy
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