Utilization of Microdissected Thin Perforator Flap Technique in the Treatment of Bulky and Deformed Skin Flaps
Utilization of Microdissected Thin Perforator Flap Technique in the Treatment of Bulky and Deformed Skin Flaps
复制标题
利用显微解剖薄穿支皮瓣技术治疗笨重和变形的皮瓣。
DOI：
10.1097/sap.0000000000001391
复制
发表时间：
2018-06-01
影响因子：
1.5
通讯作者：
Tang, Ju-Yu
中科院分区：
文献类型：
--
作者：
Zhou, Zheng-Bing;Pan, Ding;Tang, Ju-Yu
背景：本研究旨在探讨在二期翻修手术中，应用显微解剖薄穿支皮瓣技术处理大而变形的皮瓣的可行性和临床效果。方法自2013年10月至2015年10月，对17例患者采用显微解剖薄穿支皮瓣技术修复游离皮瓣修复后大而畸形的皮瓣。在显微镜下分离和保护穿支血管。保留厚度4 mm~7 mm的皮下脂肪，切除多余脂肪组织。结果17例患者术后无皮瓣坏死，创面全部愈合，无并发症发生。随访3~24个月，平均10个月。皮肤瓣保持正常的颜色和质地。受区外观和功能均有明显改善。结论利用显微解剖薄穿支皮瓣技术，在二期进一步修复较厚的薄皮瓣，一次手术即可取得良好效果。所有游离皮瓣血供均得到保留，无坏死及愈合并发症。该技术为大型自由襟翼的二次减薄提供了一种有效的方法。
Background This study investigates the feasibility and clinical impact of the microdissected thin perforator skin flap strategy on bulky and deformed skin flaps during second-stage revision surgery. Methods Seventeen patients were selected and underwent the microdissected thin perforator skin flap technique to treat bulky and deformed skin flaps after free flap reconstruction between October 2013 and October 2015. Perforator vessels were isolated and protected under a microscope. Subdermal fat with a thickness of 4 mm to 7 mm was preserved, and excess adipose tissue was resected. Results No skin flap necrosis was observed after the operation in all 17 patients, and all wounds healed without complications. Patients were followed up for 3 to 24 months, with an average follow-up time of 10 months. The skin flaps maintain normal color and texture. Both appearance and function of the recipient sites were improved significantly. Conclusions The utilization of microdissected thin perforator flap technique to further thin bulky skin flaps at the second stage can be effective in a single operation. The blood supply of all free flaps was preserved, with no evidence of necrosis or healing complications. This technique offers an effective approach for secondary thinning of bulky free flaps.