Chinese Journal of Clinical Anatomy ›› 2021, Vol. 39 ›› Issue (5): 593-597.doi: 10.13418/j.issn.1001-165x.2021.05.017

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Repair of extremity wounds with single-leaf perforated anterolateral thigh bilobed flaps connected by fascial pedicle

Liu Zhijin, Ju Jihui, Liu Shengzhe, Jin Guangzhe, Li Lei, Zhou Rong    

  1. Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou 215104, China
  • Received:2020-03-01 Online:2021-09-25 Published:2021-09-30

Abstract: Objective To explore the clinical effect of repairing limb wounds by single-leaf perforated anterolateral thigh bilobed flaps connected by fascial pedicle. Methods Twenty-four cases of limb wounds were repaired with fascial pedicled bilobed anterolateral thigh perforator flaps in our hospital from August 2013 to September 2019,  of which 18 cases were single wounds with wound area from 14cm× 7cm to 24 cm×14 cm. Five cases  had two contiguous wounds on the hand or foot, with the wound area ranging from 4 cm×4 cm to 30 cm×17 cm. One patient’s wounds located on the distal dorsal side of the left 2-5 fingers, which were also treated as two wounds. In all cases, single-leaf perforated anterolateral thigh bilobed flaps connected by fascial pedicle were designed for repairing. And the donor areas were sutured directly. Results All the bilaterally lobed flaps survived successfully and all the donor areas of thigh healed in stage I. All the patients were followed-up for 4 to 70 months, which showed that all the flaps were of good color and texture, and the sensation of the flaps recovered partially. Linear scars were remained in all donor sites. One case had a large scar area without any scar contracture, pain or other discomfort. Two cases had paresthesia in the incision area in the early postoperative period, which gradually recovered 3 months later without any other serious complications. Conclusions The application of single-leaf perforated anterolateral thigh bilobed flaps connected by fascial pedicle can solve the problem that the bilobed flap cannot be cut because of perforator variations, and reduce the width of the donor area at the same time, which effectively reducing the injury.

Key words: Anterolateral thigh flap,  Fasciocutaneous flap,  Fascial pedicle,  Bilobed flap,  Donor site injury

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