Clinical Study Of Repair Of Soft Tissue Defect In Extremities With Free Anterolateral Thigh Perforator Flap

Objective To summarize the clinical effect of anterolateral thigh pedicle or freeperforator flap in repairing soft tissue defect in the extremities.Methods From Jan2008to2011August,20cases of soft tissue with bone, tendonexposed defect were treated with pedicle or free anterolateral thigh perforator flap The defectarea ranged from8cm×6cm to20cm×12cm. The size of the flaps ranged from10cm×8cm to24cm×12cm.The flap donor site direct suture in6cases,14cases of skin graftcoverage. Neuroanastomosis was performed in11cases of the flaps.Results In all20cases,20flap ssurvived completely.20cases for the areaand incision healing stageⅠ. Flap range minimum8cm×10cm, maximum13cm×24cm. Twocases of flap edge skinnecrosis healed afterdressing treatment;In1caseafter12h bruising, immediate exploration to expand the lifting of venous crisis after the opening of the flap center.6cases of donor site width of8cm about by direct suture, take the remaining14casesof wound width greater than8cm control ateral thigh skin skin graft repair,14cases survived.And lateralfemoralcutaneousnerve anastomosis in20flaps in11cases,9casesare not consistent.20patients were followedup for a minimumofsixmonths, the longest25months. No collapseof the flapdonor area deformity, muscleweakness,muscle hernia,2cases (10%), paresthesiaof the donor site. The transplanted flap and the recipient area around the skin compared tothe similar appearance. Post-operative follow-up ranged from6to11months,the lateralfemoral cutaneous nerve of the flap after surgery:5cases of flap feeling returned to S2,6casesflaps sensory recovery to the S3. The remaining9cases did not undergo lateral femoralcutaneous nerve anastomosis of the flap, there are three cases to restore protective sensation.Conclusion The anterolateral thigh flap carried by the organization less, do not cut the vastus lateralis muscle, reduce the damage of the donor site; The anterolateralthigh flap to repair the tissue defect and the surrounding tissue of the recipientarea, improve patient satisfaction; The anterolateral thigh flap feasible lateral femoralcutaneous nerve anastomosis to the recipient area provide a good sense of recovery is to repairthe hand, foot minister strips of skin and soft tissue defect of the best choice.