CLINICAL APPLICATION OF FREE DESCENDING BRANCH OF LATERAL CIRCUMFLEX FEMORAL ARTERY PERFORATOR TISSUE FLAP AND ITS IMPACT ON DONOR SITE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JINWenhu ,  WEIZairong , DENGChengliang , SUNGuangfeng , TANGXiujun , ZHANGZiyang , ZHANGWenduo , WANGDali

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563000, P. R. China;

Corresponding author：

WEIZairong, Email: zairongwei@sina.com

Keywords：

Perforator flap; Lateral circumflex femoral artery; Fascia flap; Soft tissue injury; Wound repair

DOI：

10.7507/1002-1892.20150278

Video：

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Objective To investigate the feasibility of the free descending branch of lateral circumflex femoral artery perforator tissue flap (fascia flap plus skin flap) to repair large soft tissue defects of the extremities and its impact on the donor site. Methods Between January 2013 and February 2015, 9 cases of large tissue defects of the extremities were repaired with the free descending branch of lateral circumflex femoral artery perforator tissue flap. There were 8 males and 1 female, aged from 13 to 56 years (median, 36 years). The causes included traffic accident injury in 6 cases and crushing injury by heavy object in 3 cases. Soft tissue defect located at the lower limbs in 7 cases and at the upper limbs in 2 cases, including 2 cases of simple tendon exposure, 2 cases of simple bone exposure, and 5 cases of tendon and bone exposure. After debridement, the soft tissue defect area ranged from 13 cm×7 cm to 20 cm×18 cm. The tissue flaps ranged from 14 cm×8 cm to 23 cm×19 cm. The donor site was directly sutured, scalp graft was used to cover the fascia flap. Results After operation, partial necrosis of the skin grafting on the fascia flap occurred in 2 cases and healed after dressing change. Arterial crisis occurred in 1 case and the flap survived after anastomosis. The other tissue flaps survived and wounds healed by first intention. The skin grafting healed by first intention in 7 cases, by second intention in 2 cases. The patients were followed up 4-24 months (mean, 10 months). The appearance and function of the tissue flaps were satisfactory, only linear scar was observed at the donor site, which had less damage and no effect on walking. Conclusion Free descending branch of lateral circumflex femoral artery perforator tissue flap can repair large soft tissue defect of the extremities. The donor site can be sutured directly, which reduces damage to donor site and is accord with the principle of plastic surgery.

Citation： JINWenhu, WEIZairong, DENGChengliang, SUNGuangfeng, TANGXiujun, ZHANGZiyang, ZHANGWenduo, WANGDali. CLINICAL APPLICATION OF FREE DESCENDING BRANCH OF LATERAL CIRCUMFLEX FEMORAL ARTERY PERFORATOR TISSUE FLAP AND ITS IMPACT ON DONOR SITE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(10): 1284-1287. doi: 10.7507/1002-1892.20150278 Copy

1.	张万锋, 梁锋, 李金有, 等. 带阔筋膜的股前外侧穿支组织瓣修复组织缺损. 中华烧伤杂志, 2013, 29(5):427-431.
2.	朱新红, 吴水培, 俞立新, 等. 股前外侧分叶肌皮瓣的临床应用和研究. 中华临床医师杂志(电子版), 2011, 5(2):171-172.
3.	Wong CH, Ong YS, Wei FC. The anterolateral thigh-Vastus lateralis conjoint flap for complex defects of the lower limb. J Plast Reconstr Aesthet Surg, 2012, 65(2):235-239.
4.	Bhadkamkar MA, Wolfswinkel EM, Hatef DA, et al. The ultrathin, fascia-only anterolateral thigh flap. J Reconstr Microsurg, 2014, 30(9):599-605.
5.	张威凯, 王相, 王海兵, 等. 一期修薄游离股前外侧皮瓣修复足踝部软组织缺损. 中华整形外科杂志, 2014, 30(4):304-305.
6.	唐修俊, 魏在荣, 王波, 等. 游离旋股外侧动脉穿支KISS皮瓣修复四肢创面的临床应用. 中华显微外科杂志, 2015, 38(1):29-32.
7.	Goel S, Arora J, Mehta V, et al. Unusual disposition of lateral circumflex femoral artery:Anatomical description and clinical implications. World J Clin Cases, 2015, 3(1):85-88.
8.	Lee YC, Chen WC, Chou TM, et al. Anatomical variability of the anterolateral thigh flap perforators:vascular anatomy and its clinical implications. Plast Reconstr Surg, 2015, 135(4):1097-1107.
9.	Mavropoulos JC, Bordeaux JS. The temporoparietal fascia flap:a versatile tool for the dermatologic surgeon. Dermatol Surg, 2014, 40(9):113-119.
10.	Fox P, Endress R, Sen S, et al. Fascia-only anterolateral thigh flap for extremity reconstruction. Ann Plast Surg, 2014, 72 Suppl 1:S9-13.
11.	Denadai R, Raposo-Amaral CE, Marques FF, et al. Posttraumatic eyebrow reconstruction with hair-bearing temporoparietal fascia flap. Einstein (Sao Paulo), 2015, 13(1):106-109.
12.	陈雪松, 徐永清, 陈建明, 等. 外踝上穿支蒂腓浅神经营养血管皮肤筋膜瓣修复足背皮瓣供区. 中华整形外科杂志, 2013, 29(5): 345-348.
13.	雷林革, 袁崇喜, 何如祥, 等. 游离股前外筋膜瓣修复手部软组织缺损. 实用手外科杂志, 2013, 27(2):118-120.
14.	魏在荣. 影响皮瓣成活的血管因素分析. 中国美容整形外科杂志, 2014, 25(3):129-131.
15.	Yamada S, Okamoto H, Sekiya I, et al. Anatomical basis of distally based anterolateral thigh flap. J Plast Surg Hand Surg, 2014, 48(3): 197-200.
16.	Taylor GI, Gorlett RJ, Dhar SC, et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries:developent of the concept and designing safe flap. Plast Resonstr Surg, 2011, 127(4):1447-1459.
17.	Wei ZR, Sun GF, Wang DL, et al. Reconstruction of the Achilles tendon and overlying skin defect:3 case reports. Annals of Plastic Surgery, 2014, 73(3):325-329.
18.	魏在荣. 皮瓣命名方式探讨. 中华损伤与修复杂志(电子版), 2011, 6(3):9-11.
19.	Zhuang Y, Hu S, Wu D, et al. A novel in vivo technique for observations of choke vessels in a rat skin flap model. Plast Reconstr Surg, 2012, 130(2):308-317.

1. 张万锋, 梁锋, 李金有, 等. 带阔筋膜的股前外侧穿支组织瓣修复组织缺损. 中华烧伤杂志, 2013, 29(5):427-431.
2. 朱新红, 吴水培, 俞立新, 等. 股前外侧分叶肌皮瓣的临床应用和研究. 中华临床医师杂志(电子版), 2011, 5(2):171-172.
3. Wong CH, Ong YS, Wei FC. The anterolateral thigh-Vastus lateralis conjoint flap for complex defects of the lower limb. J Plast Reconstr Aesthet Surg, 2012, 65(2):235-239.
4. Bhadkamkar MA, Wolfswinkel EM, Hatef DA, et al. The ultrathin, fascia-only anterolateral thigh flap. J Reconstr Microsurg, 2014, 30(9):599-605.
5. 张威凯, 王相, 王海兵, 等. 一期修薄游离股前外侧皮瓣修复足踝部软组织缺损. 中华整形外科杂志, 2014, 30(4):304-305.
6. 唐修俊, 魏在荣, 王波, 等. 游离旋股外侧动脉穿支KISS皮瓣修复四肢创面的临床应用. 中华显微外科杂志, 2015, 38(1):29-32.
7. Goel S, Arora J, Mehta V, et al. Unusual disposition of lateral circumflex femoral artery:Anatomical description and clinical implications. World J Clin Cases, 2015, 3(1):85-88.
8. Lee YC, Chen WC, Chou TM, et al. Anatomical variability of the anterolateral thigh flap perforators:vascular anatomy and its clinical implications. Plast Reconstr Surg, 2015, 135(4):1097-1107.
9. Mavropoulos JC, Bordeaux JS. The temporoparietal fascia flap:a versatile tool for the dermatologic surgeon. Dermatol Surg, 2014, 40(9):113-119.
10. Fox P, Endress R, Sen S, et al. Fascia-only anterolateral thigh flap for extremity reconstruction. Ann Plast Surg, 2014, 72 Suppl 1:S9-13.
11. Denadai R, Raposo-Amaral CE, Marques FF, et al. Posttraumatic eyebrow reconstruction with hair-bearing temporoparietal fascia flap. Einstein (Sao Paulo), 2015, 13(1):106-109.
12. 陈雪松, 徐永清, 陈建明, 等. 外踝上穿支蒂腓浅神经营养血管皮肤筋膜瓣修复足背皮瓣供区. 中华整形外科杂志, 2013, 29(5): 345-348.
13. 雷林革, 袁崇喜, 何如祥, 等. 游离股前外筋膜瓣修复手部软组织缺损. 实用手外科杂志, 2013, 27(2):118-120.
14. 魏在荣. 影响皮瓣成活的血管因素分析. 中国美容整形外科杂志, 2014, 25(3):129-131.
15. Yamada S, Okamoto H, Sekiya I, et al. Anatomical basis of distally based anterolateral thigh flap. J Plast Surg Hand Surg, 2014, 48(3): 197-200.
16. Taylor GI, Gorlett RJ, Dhar SC, et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries:developent of the concept and designing safe flap. Plast Resonstr Surg, 2011, 127(4):1447-1459.
17. Wei ZR, Sun GF, Wang DL, et al. Reconstruction of the Achilles tendon and overlying skin defect:3 case reports. Annals of Plastic Surgery, 2014, 73(3):325-329.
18. 魏在荣. 皮瓣命名方式探讨. 中华损伤与修复杂志(电子版), 2011, 6(3):9-11.
19. Zhuang Y, Hu S, Wu D, et al. A novel in vivo technique for observations of choke vessels in a rat skin flap model. Plast Reconstr Surg, 2012, 130(2):308-317.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF FREE DESCENDING BRANCH OF LATERAL CIRCUMFLEX FEMORAL ARTERY PERFORATOR TISSUE FLAP AND ITS IMPACT ON DONOR SITE

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