关键词: 穿支皮瓣, 修薄, 缺损, 足

Abstract:

Objective　To explore the feasibility of the in situ one-stage thinning of the anterolateral thigh perforator flap for repairing the distal foot defects.　Methods　From Jun. 2009 to Aug. 2010, 9 cases with distal foot defects were treated with anterolateral thigh perforator flap. During the harvesting of the flap, either the deep layer of the subcutaneous fat and the deep fascia were preserved in situ (6 cases) or the whole layer of the subcutaneous fat and the deep fascia were preserved in situ (3 cases) according to the wound requirements. The donor sites were directly closed or covered with split-thickness skin grafts. The average operating time was 4.0 hours. The flap size ranged from 12×8cm～16cm×10cm.　Results　One flap had vein thrombosis postoperatively and the complication was solved after the re-exploration. The other 8 flaps healed uneventfully without any marginal necrosis. There was no skin grafts loss on the donor sites. At a 3~16 months follow up, the flaps took well with good contours. The thickness of these flaps was half of those harvested with common ways. The patients could wear the same size shoes postoperatively, and none of them required the thinning or debulking of the flaps.　Conclusions　In situ one-stage thinning of the anterolateral thigh perforator flap is a good technique for the distal foot defects. It has the advantages of the reliable blood supply, more satisfactory contours and requires no secondary thinning.

Key words: Perforator flap, Thinning, Defects, Foot