Objective: To explore the effectiveness of free lobed perforator flaps in repairing of complex wounds of limbs.
Methods: Between January 2018 and January 2021, 10 patients with complex wounds of limbs were admitted. There were 7 males and 3 females, aged from 32 to 64 years, with an average age of 45 years. There were 4 cases of traffic accident injuries, 3 cases of machine strangulation injuries, 1 case of machine crush injury, and 2 cases of heavy object crush injuries. There were 5 cases of upper limb wounds and 5 cases of lower limb wounds. The size of wounds ranged from 11 cm×10 cm to 25 cm×18 cm. The wounds were repaired with tri-lobed flaps of the descending branch of the lateral femoral circumflex artery in 7 cases, four-lobed flaps in 2 cases, and with tri-lobed flaps of the descending branch of the lateral femoral circumflex artery combined with oblique branch in 1 case. The size of flaps ranged from 12.0 cm×10.5 cm to 28.0 cm×12.0 cm. The donor sites were sutured directly in 9 cases and repaired with superficial iliac circumflex artery perforator flap in 1 case.
Results: Sinus formed at the edge of the flap in 1 patient, which healed after dressing change and drainage; other flaps survived well, and the wounds healed by first intention. The skin flap at donor site survived, and the incisions healed by first intention. All patients were followed up 6-24 months (mean, 11 months). All flaps had good appearance and function, and linear scars were left at the donor site without obvious complications.
Conclusion: Free lobed perforator flap is an alternative method to repair complex wounds of limbs with high safety, good effectiveness, and less complications.
目的: 探讨游离分叶穿支皮瓣修复四肢复杂创面的疗效。.
方法: 2018 年1月—2021 年1月，收治10例四肢复杂创面患者。男7例，女3例；年龄32～64岁，平均45岁。致伤原因：交通事故伤 4例，机器绞伤 3例，机器挤压伤 1 例，重物压砸伤 2 例。上肢创面5例，下肢创面5例。创面范围11 cm×10 cm～25 cm×18 cm。采用旋股外侧动脉降支穿支三叶皮瓣7例、四叶皮瓣2例，旋股外侧动脉降支联合斜支穿支三叶皮瓣1例。皮瓣切取范围12.0 cm×10.5 cm～28.0 cm×12.0 cm。供区直接缝合9例，接力旋髂浅动脉穿支皮瓣修复1例。.
结果: 术后1例皮瓣边缘窦道形成，经换药、引流后愈合；其余皮瓣均顺利成活，创面Ⅰ期愈合。供区皮瓣成活，切口均Ⅰ期愈合。患者均获随访，随访时间6～24个月，平均11个月。皮瓣无明显臃肿，色泽、质地良好。供区仅遗留线性瘢痕。.
结论: 游离分叶穿支皮瓣能有效修复四肢复杂创面，术后皮瓣成活率高，并发症少。.
Keywords: Free lobed perforator flap; limb; soft tissue defect; wound repair.