From January 2014 to June 2018, 12 patients with skin and soft tissue defects in shoulder and elbow were admitted to General Hospital of Ningxia Medical University with skin and soft tissue defect size of 6 cm×5 cm to 11 cm×8 cm, including 9 males and 3 females aged 15-56 years. Wounds of 5 patients were repaired with rotator scapular artery perforator flap (flap area of 8 cm×7 cm to 12 cm×6 cm), and the donor flap area was sutured directly. Wounds of 3 patients were repaired with lateral thoracic perforator flap (flap area of 8 cm×7 cm to 13 cm×9 cm). The donor flap area of two patients was sutured directly, the majority of the donor flap area of one patient was sutured directly, and a small part was covered by split-thickness skin graft from ipsilateral thigh. Wounds of 4 patients were repaired with medial brachial artery perforator flap (flap area of 6 cm×5 cm to 12 cm×10 cm). The donor flap area of two patients was sutured directly, and two patients were covered with split-thickness skin graft from left chest wall. The flaps of 11 patients survived after surgery. Blood flow disorder at the distal end of the flap was observed in one patient. After treatment, the distal end of the flap presented 3 cm×2 cm necrosis, and the skin graft survived after second skin grafting and debridement. During the follow-up of 6 to 24 months post surgery, all patients had good texture of flap, with light scar hyperplasia in the donor flap area, and good recovery of elbow and shoulder joint function. The rotator scapular artery perforator flap, lateral thoracic perforator flap, and medial brachial artery perforator flap with the advantages being of relatively simple operation, high survival rate, and good surgical outcome, are good choices for repairing the skin and soft tissue defects in shoulder and elbow.
2014年1月—2018年6月，宁夏医科大学总医院收治肩部和肘部皮肤软组织缺损患者12例，其中男9例、女3例，年龄15～56岁，皮肤软组织缺损面积6 cm×5 cm～11 cm×8 cm。5例患者创面采用旋肩胛动脉穿支皮瓣(皮瓣面积8 cm×7 cm～12 cm×6 cm)修复，供瓣区直接缝合。3例患者创面采用侧胸部穿支皮瓣(皮瓣面积8 cm×7 cm～13 cm×9 cm)修复，2例患者供瓣区直接缝合，1例患者供瓣区大部分直接缝合，小部分移植同侧大腿中厚皮覆盖。4例患者创面采用臂内侧动脉穿支皮瓣(皮瓣面积6 cm×5 cm～12 cm×10 cm)修复，2例患者供瓣区直接缝合，2例患者取左侧胸壁中厚皮覆盖。11例患者术后皮瓣成活，1例患者皮瓣远端出现血运障碍，经处理，皮瓣远端出现3 cm×2 cm坏死，经二次扩创植皮后，皮片成活。术后随访6～24个月，所有患者皮瓣质地良好，供瓣区瘢痕增生轻，肘关节及肩关节功能恢复良好。旋肩胛动脉穿支皮瓣、侧胸部穿支皮瓣、臂内侧动脉穿支皮瓣具有手术操作相对简单，皮瓣成活率高、手术效果好等优点，是修复肩部和肘部皮肤软组织缺损的较佳选择。.
Keywords: Elbow; Perforator flaps; Shoulder; Surgical flaps; Wound healing.