Efficacy of computed tomographic angiography three-dimensional reconstruction technology in repair of limb wounds using free double-leaf anterolateral thigh perforator flaps
10.3760/cma.j.cn114657-20241206-00207
- VernacularTitle:CTA三维重建技术在游离双叶股前外侧穿支皮瓣移植修复四肢创面中的效果
- Author:
Bo LAN
1
;
Shangjun FU
;
Tao LIU
;
Jianlong WU
;
Jin YANG
Author Information
1. 浙江省义乌市中心医院手足外科，义乌 322000
- Publication Type:Journal Article
- Keywords:
Angiography;
Three-dimensional reconstruction;
Anteriolateral thigh perforator flap;
Limb wound;
Vascular anastomosis rate
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2025;31(2):148-154
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of computed tomographic angiography (CTA) three-dimensional reconstruction technology in the repair of limb wounds using free double-leaf anterolateral thigh perforator flaps.Methods:A retrospective analysis was conducted on 30 patients with varying degrees of skin damage on their limbs who were admitted to the Hand and Foot Surgery Department of Yiwu Central Hospital in Zhejiang Province and Zhejiang Provincial People's Hospital from January 2015 to March 2022. The patients were divided into observation group ( n=15) and control group ( n=15) based on whether CTA three-dimensional reconstruction was performed preoperatively. In the observation group, CTA three-dimensional reconstruction was performed preoperatively, including 9 males and 6 females, aged 17-67 (49.7±4.2) years. In the control group, handheld Doppler ultrasound angiography was performed preoperatively, including 10 males and 5 females, aged 20-69 (50.4±5.0) years. Relevant intraoperative and postoperative indicators were compared between the two groups, including operation duration, anesthesia recovery time, blood loss, perforator localization accuracy, vascular anastomosis rate between the donor and recipient sites, flap harvesting time, flap survival rate, and incidence of adverse reactions. Follow-up visits were conducted via telephone or outpatient clinic for 3 months postoperatively, with one visit per month, to assess patient satisfaction rates. A multi-criteria decision-making model was established, and the benefit values, risk values, and stability of the decision-making model were evaluated for both groups. Results:Compared with the control group, the observation group had significantly reduced operation duration, anesthesia recovery time, blood loss, and flap harvesting time (all P<0.05). The patient satisfaction rate, perforator localization accuracy, and vascular anastomosis rate between the donor and recipient sites were significantly better in the observation group than in the control group (all P<0.05). The incidence of adverse reactions was 13.3% (2/15) in the observation group, which was lower than 53.3% (8/15) in the control group ( P=0.020). Among the benefit indicators, the vascular anastomosis rate between the donor and recipient sites and flap survival rate had the greatest impact on treatment outcomes. Among the risk indicators, venous crisis and flap necrosis had a greater impact. The benefit-risk value was 77 in the observation group and 56 in the control group, with a difference of 21 (95% CI: 14-26) between the two groups. The observation group had higher values than the control group within the range of 0-100% relative risk weight, indicating good stability of the multi-criteria decision-making evaluation model. Conclusion:CTA three-dimensional reconstruction technology can improve the vascular anastomosis rate between the donor and recipient sites and patient satisfaction rates in the repair of limb wounds using free double-leaf anterolateral thigh perforator flaps.
