| Chapter I The Applied Anatomic Study on Lateral Thigh Perforator FlapObjective To provide anatomic evidence for the application of the lateral thigh perforator flap.Methods Dissected six fresh Chinese adult lower limbs specimens which were frozen for 48 hours after being injected with red latex via arterial cannula. On the lateral area of middle and distal thigh, obseved the number, distribution, course, category ,length of pedicle and external diameter of the flaps'perforators on five specimens. The other specimen was simulated the operation of the lateral thigh perorator flap.The data were analyzed with SPSS 11.0 statistical software.Results On the lateral area of middle and distal thigh 19 perforator arteris were observed in these specimens, averagely there were 3.8±1.3 cutaneous perforators in each flap. Perforators mainly origined from the third perforator artery of profunda femoris, secondly from the second,fourth perforator artery and superior lateral genicular artery. Cutaneous perforators of the third perforator artery of profunda femoris pierced the flap on 13.8±1.5cm proximal of the fibulae capitulum, while the cutaneous perforators of superior lateral genicular artery on 8.6±1.3cm proximal of the fibulae capitulum . Averagely internal diameter of cutaneous perforators was 0.7±0.2mm at the point where the perforators pierced deep fascia. The diameter of the profunda femoris was 1.9±0.2mm ,and the pedicle length was 12.2±0.6cm. The diameter of superior lateral genicular artery was 1.5±0.2mm,and the pedicle length was 6.8±1.1cm.There were inosculated branch in these perforators which came from profunda femoris and superior lateral genicular artery.Conclusion The anatomic characteristic allowed this flap would likely be clinically useful in repairing soft tissue defects in extremity limbs as a free or pedicled flap,which the cutaneous perforators invariably appeared on the skin of lateral areat of middle and distal thigh ; the flap could obtain enough length of the pedicle from its origination; the vessel has large caliber supporting a substantial cutaneous territory .Chapter II Clinical Application Study of Lateral Thigh Perforator FlapObjective To probe the feasibility and therapeutic effect of the lateral thigh perforator flap for repairing soft tissue defects in extremity limbs.Methods Combinating the detection of the colour doppler ultrasound preoperatively,13 lateral thigh perforator flaps were applyied to repair different defect ,in which one was pedicled flap and 12 were free flaps .Two of them applied vessel anastomosis in series with anterlateral thigh perforator flap .The axis was from the fibulae capitulum to greater trochanter of femur, the center of these flaps was on 13.8±1.5cm proximal of the fibulae capitulum.Results All 13 flaps surived completely.In 3-6 months follow-up , all flaps were with thin and good appearance , and they were characterized by soft texture and good colour .No chimatlon and ulcer appeared in any flap . There were no effect of motor function in donor site because of muscle conglutination and scar contracture. There were plainness figure in donor site where skin- grafing was used,and only linearity scar remained where sewed directly.Conclusion The lateral thigh flap had correspondingly constant perforator origination ,and provided with thin and pleasing appearance, soft texture and minor morbidity in donor site and correspondingly easy dissection . It was feasiblely to repair middling to little skin and soft tissue defect in extremity limbs as a free flap,and to repair skin and soft tissue defect in knee and popliteal space as a pedicel flap.It could apply vessel anastomosis in series with anterlateral thigh perforator flap for repairing large defect. |
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