End-to-side anastomosis of non-primary perforating vessels of free anterolateral thigh perforator flap in reconstruction of soft tissue defect of limb: a report of 14 cases
10.3760/cma.j.cn441206-20230911-00033
- VernacularTitle:端侧吻合非一级源血管的游离股前外侧穿支皮瓣修复四肢软组织缺损14例
- Author:
Tao MA
1
;
Fei MENG
;
Hongjiu QIN
Author Information
1. 皖南医学院第一附属医院手足外科，安徽 芜湖 241000
- Keywords:
Anterolateral thigh perforator flap;
Limbs;
Soft tissue defect;
Repair;
End-to-side anastomosis
- From:
Chinese Journal of Microsurgery
2024;47(1):34-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effects of end-to-side anastomosis of non-primary perforating vessels carried by free anterolateral thigh perforator flap (ALTPF) in reconstruction of soft tissue of limb.Methods:Between February 2020 and July 2021, 14 patients with soft tissue defect of limb were admitted in the Department of Hand and Foot Surgery, the First Affiliated Hospital of Wannan Medical College. The patients were 12 males and 2 females, aged between 30 and 69 years old, with a median age of 52 years old. One defect was found in left hand, 7 in left foot and ankle and 6 in right foot and ankle. Wound sizes were 7 cm×7 cm-9 cm×22 cm, all accompanied with exposed tendons, nerves or bone tissue. The size of flaps ranged from 8 cm×8 cm to 10 cm×23 cm. ALTPFs carrying non-primary source vessels were applied in reconstruction of soft tissue defects. The non-primary perforating vessels of ALTPF was anastomosed with the artery in recipient site in an end-to-side fashion and the vein of ALTPF was end-to-end anastomosed with the accompanying vein of the recipient artery. All donor sites were sutured directly. The follow-up was conducted by online reviews via WeChat or by visit of outpatient clinics. Appearance of flap and donor site were observed and the aesthetic satisfaction of the patients recipient sites were assessed subjectively using Likert scale.Results:All 14 ALTPFs survived uneventfully. Wound exudation occurred in 1 flap, and healed after dressing change and drainage. All patients received 9-18 (mean 12.6) months of follow-up. The ALTPFs were in good texture and shape. According to the Likert scale, appearance were excellent in 4 flaps, good in 8 flaps and fair in 2 flaps.Conclusion:Application of free ALTPF of non-primary source vessels with end-to-side anastomosis is not only effective in the reconstruction of limb defects, but also has advantages of reliable blood perfusion and cosmetic appearance.
