Selection strategy of superficial iliac circumflex artery and lateral circumflex femoral artery perforator flap in wound repair
10.3760/cma.j.issn.1009-4598.2019.10.004
- VernacularTitle: 旋髂浅动脉穿支皮瓣与旋股外侧动脉穿支皮瓣分别切取、联合切取在创面修复中的应用
- Author:
Hai LI
1
;
Zairong WEI
1
;
Shusen CHANG
1
;
Chengliang DENG
1
;
Wenhu JIN
1
;
Wenduo ZHANG
1
;
Xiujun TANG
1
;
Kaiyu NIE
1
Author Information
1. Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China
- Publication Type:Clinical Trail
- Keywords:
Surgical flap;
Superficial iliac circumflex artery perforator flap;
Lateral circumflex femoral artery perforator flap;
Perforator flap
- From:
Chinese Journal of Plastic Surgery
2019;35(10):966-972
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To provide clinical guidance for clinical selection, through retrospective analysis for the advantages and disadvantages of superficial iliac circumflex artery and lateral circumflex femoral artery perforator flap in wound repair.
Methods:From July 2016 to January 2018, 89 cases were repaired with superficial iliac circumflex artery or lateral femoral circumflex artery perforator flap, including 32 cases of superficial circumflex iliac artery perforator flap, 18 cases of upper limb, 6 cases of face and neck, and 8 cases of lower extremity. There were 52 cases of lateral circumflex femoral artery perforator flap, 21 cases of upper limb, 2 cases of neck, 3 cases of trunk, 26 cases of lower extremity, 5 cases of superficial circumflex iliac artery perforator flap combined with lateral femoral circumflex artery perforator flap, 3 cases of upper limb and 2 cases of lower extremity. The perforators of superficial circumflex iliac artery or (and) lateral circumflex femoral artery were detected by portable Doppler flow detector before operation. According to the wound size, the superficial circumflex artery perforator flap or (and) lateral circumflex femoral artery perforator flap was or (were) designed and resected. End-to-end or end-to-side anastomosis was performed in vascular pedicle. In the combined resection group, the end-to-end or end-to-side anastomosis of the perforator of the lateral circumflex thigh artery was performed, and the pedicled part of the superficial circumflex iliac artery was used for supercharging.
Results:All the flaps survived successfully except one combined flap had tip necrosis on the superficial iliac circumflex artery perforator flap part. and healed after 2 weeks of dressing change. Venous crisis occurred on the first day after operation of superficial iliac circumflex artery perforator flap in 1 case.10 cases of lateral femoral circumflex artery perforator flap were slightly bloated and 3 cases returned to hospital for secondary thinning. All the flaps were soft in texture, satisfactory in shape and function, and numbed in the small area of the donor region of the perforator flap of lateral femoral circumflex artery in the early stage. All the patients had no severe complications after follow-up.
Conclusions:The perforator flap of superficial iliac circumflex artery and lateral femoral circumflex artery are ideal donor areas for wound repair. The perforator flap of superficial iliac circumflex artery is preferred for small area wound, hand wound and small bone defect. Lateral circumflex femoral perforator flap is suitable for all trunk and limbs with large or complex wounds.
