关键词: 外科皮瓣, 旋股外侧动脉, 修薄, 软组织缺损, 修复重建手术

Abstract:

Objective　To investigate the effect of clinical application of the micro-debulking perforator flap based on the descending branch of the the lateral circumflex femoral artery.　Methods　Between May 2014 and January 2016, 26 cases of tissue defects of the hands and feet were repaired with the micro-debulking perforator flaps based on the descending branch of the lateral circumflex femoral artery. The soft tissue defect area ranged from 6 cm×4 cm to 15 cm×10 cm. The flaps ranged from 8 cm×5 cm to 21 cm×8 cm. According to the second-perforator course，the perforator and the deep fascia about 1 mm around it were preserved under a magnifying glass before cutting off the pedicle. The peripheral fat tissue was removed to the utmost extent. 2~3 mm thick circumferential fat tissues of the flaps were preserved. The flaps were transplanted to recipient site after excellent blood perfusion of the flaps was checked.15 cases are swelled obviously postoperatively, which was managed by re-open one edge of the flaps to remove the fatty tissue.　Results     Twenty-five flaps survived completely. Only one flap suffered partial margin necrosis with a size of 2 cm ×1cm, which was healed after dressing change for two weeks. Fifteen cases with centrally-located bulk was thinned in a second phase. Patients were followed up for 6 to 20 months. The appearance of flaps was satisfactory and the texture was thin and soft, and the sensation was numb.only linear scars could be seen in the donor site.    Conclusions    The perforator flap based on the descending branch of lateral circumflex femoral artery can withstand the removal of most of the deep fascia and superficial fascia tissue. If necessary, the central fat tissue of the flaps was removed in asecond phase, reducing the number of plastic surgery and the difficulty of operation.

Key words: Surgical flaps, Lateral circumflex femoral artery, Thinning, Soft tissue defect, Reparative and reconstructive surgery