The applications of cross-bridge free flap for reconstructions of severe soft tissue defects
10.3760/cma.j.cn114453-20210601-00241
- VernacularTitle:游离皮瓣桥式移植修复严重皮肤软组织缺损
- Author:
Jiaomiao PEI
1
;
Yan HAN
;
Yang LI
;
Juan ZHANG
;
Baoqiang SONG
Author Information
1. 空军军医大学第一附属医院整形外科，西安 710032
- Keywords:
Microsurgery;
Surgical flaps;
Ross-bridge transplantation;
Free skin flap;
Soft tissue defect
- From:
Chinese Journal of Plastic Surgery
2022;38(4):402-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application and efficacy of cross-bridge free flap to repair severe soft tissue defects.Methods:The clinical data of severe defects with vascular damage in recipient site from February 2008 to February 2017 was retrospectively analyzed in the First Affiliated Hospital of Air Force Military Medical University. Latissimus dorsi myocutaneous flaps, anterolateral thigh flaps or thoracomphalum flaps were applied in these cases. These flaps were nourished by ipsilateral or contralateral limb vessels which named bridge blood supply. The radial artery and cephalic vein of ipsilateral forearm were bridged for repairing defects of head, face and trunk. The vessels of the unaffected lower extremity were bridged to repair leg and foot wounds. The flap donor sites were closed directly or resurfaced by skin grafting. Division procedures were performed after circulation reestablished for 5 weeks. The complications, survival of flaps and skin grafts were observed and followed up.Results:A total of 12 patients were selected, including 9 males and 3 females, aged 18-59 years old. The cases consisted of 4 head and facial defects, 1 hip tumor excision, 6 lower extremities and 1 dorsal foot injuries. The defect areas were ranged 18. 0cm×7. 0 cm- 23. 5 cm × 13. 0 cm, and the flaps were harvested by 20. 0 cm× 8. 0 cm- 25. 0 cm× 15. 0 cm. Latissimus dorsi myocutaneous flaps were applied in 10 cases. The other two cases were treated by thoracic umbilical and anterolateral thigh flap. Vascular crisis occurred in 1 case, and the graft survived well after venous thrombosis removed timely. One case of partial skin graft necrosis occurred on the back donor site which healed after dressing changes. The other donor sites recovered well. Two cases of flap bloating appearances were improved by thinning procedures six months later. The follow-ups were lasted 1 to 1. 5 years. The patients were satisfied with the appearance of the transferred flaps. The color and texture of the flaps were different from the surrounding areas. There were no malformations and functional disorders in donor sites of the extremities. But some pigmentation and superficial scar was left on the thighs.Conclusions:For large and severe soft tissue defect where no anastomotic vessels available, the application of free flap by bridge transplantation is an alternative for good outcomes.
