“泳裤供区”理念下探讨旋髂浅动脉穿支皮瓣修复四肢软组织缺损的临床应用

doi:10.13418/j.issn.1001-165x.2022.5.15

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (5): 587-591.doi: 10.13418/j.issn.1001-165x.2022.5.15

“泳裤供区”理念下探讨旋髂浅动脉穿支皮瓣修复四肢软组织缺损的临床应用

孙钰¹, 杨利学¹, 王官林¹, 朱伟¹, 仇永锋¹*, 梁浩浩²

1.陕西中医药大学附属医院，咸阳 712000； 2.西安市红会医院，西安 710000

收稿日期:2021-12-30 出版日期:2022-09-25 发布日期:2022-10-13
通讯作者: 仇永峰，主治医师，博士，E-mail:a18391076233@163.com
作者简介:孙钰（1997-），男，陕西汉中人，硕士，研究方向：四肢骨关节与软组织的创伤修复，E-mail:973056995@qq.com
基金资助:
陕西省自然科学基础研究计划（2018JM7128）；咸阳市科技成果推广计划（2018KT-50）；陕西省教育厅项目（18JK0210）

The clinical application of superficial circumflex iliac artery perforator flaps in repairing soft tissue defects of extremities under the concept of "swimming trunks donor area"

Sun Yu¹, Yang Lixue¹, Wang Guanlin¹, Zhu Wei¹, Qiu Yongfeng¹* , Liang Haohao²

1.Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, Shaanxi Province, China; 2. Xi'an Hong Hui Hospital, Xi'an 710000, Shaanxi Province, China

Received:2021-12-30 Online:2022-09-25 Published:2022-10-13

摘要/Abstract

摘要： 目的探讨基于“泳裤供区”理念设计旋髂浅动脉穿支皮瓣（SCIP)修复四肢皮肤软组织缺损的可靠性与临床疗效。方法回顾性分析自2019年9月至2020年6月我院创伤骨科收治的四肢皮肤软组织缺损患者38例。其中男性26例，女性12例。损伤部位：手部缺损17例，足部缺损21例。软组织缺损面积：1.3 cm×1.7 cm~12 cm×8 cm。所有患者均采用游离SCIP进行修复。皮瓣切取面积：1.6 cm×2.1 cm~15 cm×11 cm。术后常规给予抗感染、抗凝、抗痉挛、保温等治疗并定期随访。结果 38例皮瓣均得到有效随访8~14月，平均10.4月，所有皮瓣均顺利成活。2例皮瓣术后出现血管危象，1例给予活血解痉等处理后顺利成活，1例抬高患肢后自行缓解。余皮瓣血液循环良好，外形与功能恢复满意，供区仅留存线状瘢痕。结论 “泳裤供区”理念下设计游离SCIP修复四肢软组织缺损，其综合了受区移植后的功能与外形，亦兼顾了供区位置与美观程度，且并发症少。为修复四肢软组织缺损的较佳选择，值得临床进一步推广应用。

关键词: 旋髂浅动脉； , , 穿支皮瓣； , , 泳裤供区； , , 四肢； , , 软组织缺损

Abstract: Objective To investigate the reliability and clinical efficacy of the superficial circumflex iliac artery perforator flap (SCIP) designed on the concept of "swim trunk donor site" in repairing skin and soft tissue defects of extremities. Methods Thirty-eight patients with skin and soft tissue defects of extremities admitted to the department of Traumatology and Orthopedics of our hospital from September 2018 to June 2020 were analyzed retrospectively, including 26 males and 12 females. The injury site included hand defects in 17 cases and foot defects in 21 cases. Soft tissue defect area was 1.3 cm×1.7 cm~12 cm×8 cm. All patients were repaired with free SCIP. The area of the skin flap was 1.6 cm×2.1 cm~15 cm×11 cm. Anti-infection, anticoagulation, anti-spasm, and heat preservation treatments were routinely given after the operation and regular follow-ups were performed. Results Thirty-eight cases of skin flaps were followed up for 8-14 months, with an average of 10.4 months; all skin flaps survived successfully. Two cases had vascular crisis after flap operation, and 1 case survived smoothly after activating blood circulation and antispasmodic treatment, one case relieved spontaneously after raising the affected limb. The remaining flap had good blood circulation, and the appearance and function recovered satisfactorily. Only linear scars remained in the donor area of the flap. Conclusions Under the concept of "swimming trunks supply area", free SCIP is designed to repair soft tissue defects of limbs, which integrates the function and appearance of the transplanted area, and also takes into account the location and aesthetic degree of the donor area, with few complications. As a better choice for repairing soft tissue defects in limbs, it is worthy of further clinical application.

Key words: Superficial circumflex iliac artery； , , Perforator flap； , , Swimming trunk donor area, Limbs; , , Soft tissue defect

中图分类号:

R616.2
R628

孙钰, 杨利学, 王官林, 朱伟, 仇永锋, 梁浩浩. “泳裤供区”理念下探讨旋髂浅动脉穿支皮瓣修复四肢软组织缺损的临床应用[J]. 中国临床解剖学杂志, 2022, 40(5): 587-591.

Sun Yu, Yang Lixue, Wang Guanlin, Zhu Wei, Qiu Yongfeng , Liang Haohao. The clinical application of superficial circumflex iliac artery perforator flaps in repairing soft tissue defects of extremities under the concept of "swimming trunks donor area"[J]. Chinese Journal of Clinical Anatomy, 2022, 40(5): 587-591.

参考文献 18

[1]	McGregor IA, Jackson IT. The groin flap[J]. Br J Plast Surg, 1972, 25(1):3-16. DOI: 10.1016/s0007-1226(72)80003-1.
[2]	杨东岳, 顾玉东, 吴敏明, 等. 超长游离皮瓣的移植[J].上海医学, 1979(5): 7-9, 66.
[3]	Daniel RK, Taylor GI. Distant transfer of an island flap by microvascular anastomoses. A clinical technique[J]. Plast Reconstr Surg, 1973, 52(2):111-117. DOI: 10.1097/00006534-197308000-00001.
[4]	Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle[J]. Br J Plast Surg, 1989, 42(6):645-648. DOI: 10.1016/0007-1226(89)90075-1.
[5]	Koshima I, Nanba Y, Tsutsui T, et al. Superficial circumflex iliac artery perforator flap for reconstruction of limb defects[J]. Plast Reconstr Surg, 2004,113(1):233-240. DOI:10.1097/01.PRS.0000095948. 03605.20.
[6]	唐举玉, 魏在荣, 张世民, 等. 穿支皮瓣的临床应用原则专家共识[J]. 中国临床解剖学杂志, 2016, 34(1):4-5. DOI: 10.13418/j.issn.1001-165x. 2016.01.002.
[7]	方杰, 陈步国, 吴尧, 等. 腓肠内侧动脉穿支皮瓣临床应用研究进展[J].中国修复重建外科杂志, 2021, 35(4): 508-513. DOI:10.7507/1002-1892.202011032.
[8]	王辉, 杨晓溪, 刘冰冰, 等.手部三种近位带蒂皮瓣接力修复手指指端脱套伤及供区软组织缺损的效果[J]. 中华烧伤杂志, 2021, 37(1):64-69. DOI:10.3760/cma.j.cn501120-20200103-00001.
[9]	劳杰. 复旦大学附属华山医院手外科的皮瓣研究进展[J]. 中华手外科杂志, 2021, 37(3): 205-206. DOI:10.3760/cma.j.cn311653-20210222-06805.
[10]	刘元波, 王欣, 张世民, 等. "带蒂穿支皮瓣常见并发症原因分析与防治"专家共识[J].中华显微外科杂志, 2017,40(2):105-108. DOI: 10.3760/cma.j.issn.1001-2036.2017.02.001.
[11]	魏在荣, 常树森. 穿支皮瓣简述[J].中华烧伤杂志, 2019, 35(7): 481-485. DOI: 10.3760/cma.j.issn.1009-2587.2019.07.001.
[12]	张敬良.努力追求创面修复的"泳裤供区"理念[J].中华显微外科杂志, 2020， 43(1): 3-4.DOI:10.3760/cma.j.issn.1001-2036.2020.01.002
[13]	Penteado CV. Contribution of the superficial and deep circumflex iliac arteries to the blood supply of the anterior third of the iliac crest and adjacent skin[J]. Anat Clin,1984,5(4):273-274. DOI:10.1007/BF01798751.
[14]	dei Piñal F, García-Bernal FJ, Studer A, et al. Super-thinned iliac flap for major defects on the elbow and wrist flexion creases.[J]. J Hand Surg Am, 2008, 33(10):1899-1904. DOI: 10.1016/j.jhsa.2008.09.023.
[15]	Huang D, Wang HW, Wang HG, et al. Reconstruction of soft tissue defect of the extremity with the perforator flap from inguinal region.[J]. Chin Med J (Engl), 2009,122(23):2861-2864. DOI: 10.3760/cma.j.issn.0366-6999.2009.23.011.
[16]	Sinna R, Hajji H, Qassemyar Q, et al. Anatomical background of the perforator flap based on the deep branch of the superficial circumflex iliac artery (SCIP Flap): a cadaveric study.[J]. Eplasty. 2010,18(10):e11. DOI:10.1.1.355.8784.
[17]	曾昂. 旋髂浅动脉穿支皮瓣的数字化解剖研究及其修复面部缺损的临床研究[D]. 北京协和医学院, 2012. DOI:10.7666/d.Y2340237.
[18]	Iida T, Mihara M, Yoshimatsu H, et al. Versatility of the superficial circumflex iliac artery perforator flap in head and neck reconstruction.[J]. Ann Plast Surg,2014,72(3):332-336. DOI:10.1097/SAP. 0b013e 318260a3ad.

“泳裤供区”理念下探讨旋髂浅动脉穿支皮瓣修复四肢软组织缺损的临床应用

The clinical application of superficial circumflex iliac artery perforator flaps in repairing soft tissue defects of extremities under the concept of "swimming trunks donor area"

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