Design and clinical application of the free chimeric peritoneal-deep inferior epigastric artery perforator flap in reconstruction of extremities
10.3760/cma.j.issn.1001-2036.2015.06.004
- VernacularTitle:游离腹膜瓣和腹壁下动脉穿支皮瓣构建嵌合瓣修复四肢大创面的设计与临床应用
- Author:
Enqi GUO
;
Qingping XIE
;
Xinyan WANG
;
Ziguan ZHU
;
Liang WANG
- Publication Type:Journal Article
- Keywords:
Chimeric flap;
Deep inferior epigastric artery;
Perforator flap;
Laparoscopy;
Extremities;
Reconstruction;
Exposed tendons
- From:
Chinese Journal of Microsurgery
2015;38(6):530-534
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the reliability and effect of using the chimeric flap retrieved by laparoscopic surgery to cover the large defect of the extremities.Methods The debridement and vacuum sealing drainage (VSD) were performed on 18 patients, who were admitted due to the defects of the extremities.The free chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap assisted by laparoscopic surgery was transplanted to cover the defect with exposed tendons and/or skeleton.Results The remaining defects of the extremities were 12 cm × 8 cm-30 cm × 17 cm.The peritoneal component of the chimeric flaps measuring 8 cm × 6 cm -14 cm × 10 cm retrieved by laparoscopic surgery was used to cover the tendons, bones and joints.The deep inferior epigastric artery perforator (DIEP) flaps measuring 13 cm × 10 cm-32 cm × 18 cm allowed the cutaneous coverage of wounds.The chimeric flaps survived completely excepting two patients.The two patients experienced partial necrosis of the chimeric flaps and received skin grafting to achieve the wound closure.The function of the injured extremities recovered partially after 6-18 months of follow-up.No abdominal pain, distension, herniation,bulging and intestinal obstruction were recorded.Conclusion The chimeric flap assisted by laparoscopy is a helpful, safe and effective method for reconstruction of large wounds in extremities with exposed tendons and bones.
