Application of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHENG Yongjian ,  WEI Zairong , LI Hai , JIN Wenhu , DENG Chengliang , NIE Kaiyu , XIAO Shune , HUANG Guangtao , WANG Dali

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

Corresponding author：

WEI Zairong, Email: zairongwei@sina.com

Keywords：

Anteromedial thigh perforator flap; lower limb; soft tissue defect; wound repair

DOI：

10.7507/1002-1892.201905019

Video：

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Objective To investigate effectiveness of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs.Methods Between January 2015 and October 2018, 7 patients with soft tissue defects of the lower limbs were repaired with the anteromedial thigh perforator flaps. The patients were males, aged 8-30 years (median, 23 years). There were 5 cases of traffic accident injuries (the time from injury to admission was 1-4 hours, with an average of 1.5 hours), 1 case of scar formation after traffic accident, and 1 case of scar deformity after burn. The defect located in calf in 5 cases, foot in 1 case, and thigh in 1 case. The area of soft tissue defects ranged from 12 cm×4 cm to 21 cm×7 cm; and the area of flaps ranged from 14 cm×5 cm to 24 cm×8 cm. The donor sites were sutured directly.Results The flaps survived completely after operation in 6 cases, and the wounds healed by the first intention; the partial necrosis of flap occurred and healed after skin graft repair in 1 case. One incision partially ruptured in the donor site and healed after dressing change; the other incisions healed by the first intetion. All patients were followed up 6 months to 2 years with an average of 9 months. Except 1 case complained of edema of the flap, the other patients had good shape, good color, and no swelling.Conclusion For patients with soft tissue defects of lower limbs that cannot be repaired with anterolateral thigh perforator flap, the anteromedial thigh perforator flap can be used for good results.

Citation： ZHENG Yongjian, WEI Zairong, LI Hai, JIN Wenhu, DENG Chengliang, NIE Kaiyu, XIAO Shune, HUANG Guangtao, WANG Dali. Application of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(12): 1552-1555. doi: 10.7507/1002-1892.201905019 Copy

1.	Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg, 1989, 42(6): 645-648.
2.	宋达疆, 李赞, 周晓, 等. 游离带感觉超薄股前外侧穿支皮瓣修复踇甲瓣供区创面的疗效观察. 中国修复重建外科杂志, 2017, 31(8): 987-991.
3.	朱跃良, 殷作明, 王家祥, 等. 股前外侧穿支皮瓣切取技巧分析. 中国修复重建外科杂志, 2017, 31(1): 57-61.
4.	杨林, 刘宏君, 张文忠, 等. 改良股前外侧游离穿支皮瓣桥式交叉移植修复小腿中下段软组织缺损. 中国修复重建外科杂志, 2017, 31(10): 1240-1244.
5.	宋达疆, 李赞, 周晓, 等. 游离分叶股前外侧穿支皮瓣修复口腔颌面部恶性肿瘤术后颊部洞穿缺损. 中国修复重建外科杂志, 2018, 32(5): 607-611.
6.	张树新, 邹旭, 许永先, 等. 股前外侧皮瓣修复前臂及手部热压伤五例. 中华显微外科杂志, 2018, 41(1): 72-74.
7.	刘龙灿, 刘元波, 臧梦青, 等. 以股直肌支穿支为蒂的逆行股前内侧皮瓣临床应用研究. 中国修复重建外科杂志, 2016, 30(12): 1502-1506.
8.	吴春, 谭莉, 王正理, 等. 股内侧肌穿支皮瓣游离移植修复手或足部皮肤软组织缺损. 中华显微外科杂志, 2018, 41(2): 172-174.
9.	杨晓东, 丁茂超, 梅劲, 等. 股前内侧穿支皮瓣的应用解剖学研究. 中国临床解剖学杂志, 2011, 29(6): 624-628.
10.	Tayfur V, Magden O, Edizer M, et al. Anatomy of the anteromedial thigh flap based on the oblique branch of the descending branch of the lateral circumflex femoral artery. Folia Morphol (Warsz), 2016, 75(1): 101-106.
11.	Cigna E, Chen HC, Ozkan O, et al. The anteromedial thigh free flap anatomy: a clinical, anatomical, and cadaveric study. Plast Reconstr Surg, 2013, 133(2): 420-429.
12.	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.
13.	魏在荣, 孙广峰, 唐修俊, 等. 腘窝中间动脉蒂混合供血皮瓣修复儿童腘窝瘢痕挛缩. 中国修复重建外科杂志, 2012, 26(8): 946-949.
14.	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.
15.	李海, 邓呈亮, 魏在荣, 等. 分叶股前外侧穿支皮瓣在血管蒂保护中的作用研究. 中国修复重建外科杂志, 2017, 31(10): 1245-1249.

1. Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg, 1989, 42(6): 645-648.
2. 宋达疆, 李赞, 周晓, 等. 游离带感觉超薄股前外侧穿支皮瓣修复踇甲瓣供区创面的疗效观察. 中国修复重建外科杂志, 2017, 31(8): 987-991.
3. 朱跃良, 殷作明, 王家祥, 等. 股前外侧穿支皮瓣切取技巧分析. 中国修复重建外科杂志, 2017, 31(1): 57-61.
4. 杨林, 刘宏君, 张文忠, 等. 改良股前外侧游离穿支皮瓣桥式交叉移植修复小腿中下段软组织缺损. 中国修复重建外科杂志, 2017, 31(10): 1240-1244.
5. 宋达疆, 李赞, 周晓, 等. 游离分叶股前外侧穿支皮瓣修复口腔颌面部恶性肿瘤术后颊部洞穿缺损. 中国修复重建外科杂志, 2018, 32(5): 607-611.
6. 张树新, 邹旭, 许永先, 等. 股前外侧皮瓣修复前臂及手部热压伤五例. 中华显微外科杂志, 2018, 41(1): 72-74.
7. 刘龙灿, 刘元波, 臧梦青, 等. 以股直肌支穿支为蒂的逆行股前内侧皮瓣临床应用研究. 中国修复重建外科杂志, 2016, 30(12): 1502-1506.
8. 吴春, 谭莉, 王正理, 等. 股内侧肌穿支皮瓣游离移植修复手或足部皮肤软组织缺损. 中华显微外科杂志, 2018, 41(2): 172-174.
9. 杨晓东, 丁茂超, 梅劲, 等. 股前内侧穿支皮瓣的应用解剖学研究. 中国临床解剖学杂志, 2011, 29(6): 624-628.
10. Tayfur V, Magden O, Edizer M, et al. Anatomy of the anteromedial thigh flap based on the oblique branch of the descending branch of the lateral circumflex femoral artery. Folia Morphol (Warsz), 2016, 75(1): 101-106.
11. Cigna E, Chen HC, Ozkan O, et al. The anteromedial thigh free flap anatomy: a clinical, anatomical, and cadaveric study. Plast Reconstr Surg, 2013, 133(2): 420-429.
12. 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.
13. 魏在荣, 孙广峰, 唐修俊, 等. 腘窝中间动脉蒂混合供血皮瓣修复儿童腘窝瘢痕挛缩. 中国修复重建外科杂志, 2012, 26(8): 946-949.
14. 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.
15. 李海, 邓呈亮, 魏在荣, 等. 分叶股前外侧穿支皮瓣在血管蒂保护中的作用研究. 中国修复重建外科杂志, 2017, 31(10): 1245-1249.

Chinese Journal of Reparative and Reconstructive Surgery

Application of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs

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