The application of multiple end-to-side anastomosis in free anterolateral thigh perforator flap transplantation
10.3760/cma.j.issn.1001-2036.2019.01.004
- VernacularTitle:多个端侧吻合口吻合方式在游离股前外侧穿支皮瓣移植中的应用
- Author:
Zhenjie MA
1
;
Shengjun YU
;
Xiao LI
;
Jingning LI
;
Yuan JI
;
Junjie JIANG
;
Honglei DOU
Author Information
1. 烟台市烟台山医院手外科 264001
- Keywords:
Anterolateral thigh perforator flaps;
Vascular anastomosis;
End-to-side anastomosis;
Repair;
Microsurgical technique
- From:
Chinese Journal of Microsurgery
2019;42(1):9-12
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical application effect of multiple end-to-side anastomosis in free anterolateral thigh perforator flap transplantation.Methods From January,2013 to October,2017,29 cases were applied the technology of multiple end-to-side anastomosis to the same recipient vessel in anterolateral thigh perforator flap transplantation for wound repair.Fifteen cases treated with multiple end-to-side anastomosis on flap arteries,and 2-3 arteries were anastomosed,with the average of 2.13.Nine cases were treated with venous multiple end-to-side anastomosis,and 2-4 veins were anastomosed,with the average of 3.11.Five cases treated with arterial and venous multiple end-to-side anastomosis,and 4-6 vessels were anastomosed,with the average of 5.20.Distribution of wounds:10 cases with hands and wrists wounded,15 cases with forearms and elbow joints wounded,and 4 cases with lower legs and feet wounded.The soft tissue defect size was 5 cm×13 cm-11 cm×27 cm,and the flap area was 6 cm× 15 cm-12 cm×29 cm.Postoperative followed-up was performed every 3-6 months to review flap survival.Results All flaps of 29 cases survived.Venous congestion occurred in 2 flaps within 48 h after the operation,among which,1 was overcomed after released the dressing and sutures,and the other underwent surgical exploration.The venous end-to-side anastomotic stomas were unobstructed,and hematoma was formed.After the hematoma compression was removed,circulation was recovered and the flap survived.With followed-up for 6 months to 2.5 years,both donor site and recipient site of the flaps healed well and the injured distal limbs had no hemodynamic disorder.Conclusion The application of multiple end-to-side anastomosis to the same recipient vessel for free transplantation of anterolateral thigh perforator flaps is safe and reliable.
