Reverse-flow thigh flaps based on the different branches of the lateral circumflex femoral artery
10.3760/cma.j.issn.1009-4598.2017.s1.013
- VernacularTitle:以旋股外侧动脉不同分支为蒂的大腿反流灌注皮瓣的分型研究和临床应用
- Author:
Qiang DING
1
;
Yuanbo LIU
;
Mengqing ZANG
;
Shan ZHU
;
Bo CHEN
;
Shanshan LI
;
Jianhua ZHANG
;
Cai WANG
;
Tao PENG
;
Longcan LIU
;
Liya JIANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院整形十一科
- Keywords:
Reverse flow;
Hemoperfusion;
Flap;
Thigh;
Lateral circumflex femoral artery;
Knee joint
- From:
Chinese Journal of Plastic Surgery
2017;33(z1):61-68
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and technical tips of the reconstruction of defects around the knee using the reverse-flow thigh flaps based on different branches of the lateral circumflex femoral artery ( LCFA) .A classification method of these flaps was proposed .Methods According to the characteristics of the defects and the LCFA arborizing condition , an optimal reverse-flow thigh flap was chosen for defect reconstruction .Results From 2010 to 2016, 23 patients underwent defect reconstruction using the reverse-flow thigh flaps .The flaps were classified into four different types according to the origin of the perforating vessels on which the flap was based , including the descending ( typeⅠ) , oblique ( typeⅡ) , rectus femoris ( type Ⅲ) , and transverse branches ( type Ⅳ) .In our series of patients , 7 type Ⅰflaps, 10 typeⅡ, 5 typeⅢ, and 1 typeⅣwere included.The reverse flow from the rectus femoris branch was combined and a dual pedicle was formed in 5 patients.The flap size ranged from 8 cm ×7cm to 24 cm × 12 cm.The perforating vessels included septocutaneous in 7 cases and musculocutaneous in the remaining 16.The pedicle length and distance from the pivot point to the superolateral border of the patella were 8.5 cm to 25 cm (mean, 17 cm) and 5 cm to 16 cm (mean, 11.48 cm) respectively.Pre-transfer donor site expansion was conducted in 5 patients.The donor sites were managed by direct closure in 18 cases, free skin grafting in 4, and transferring a pedicled deep inferior epigastric artery perforator flap in the remaining 1.All flaps survived after the surgery except one in which the venous congestion of the flap occurred postoperatively , resolved after using conservative treatment .The patients were followed for 1 to 48 months, tumor recurrence was not noticed and all patients were satisfied with the reconstructive outcomes .Conclusions LCFA-based classification system of the reverse-flow thigh flaps would provide surgeons more options when a defect around knee needs to be reconstructed .
