Journal of Trauma and Injury

  • 제20권2호
  • /
  • Pages.119-124
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  • 2007
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

전외측 대퇴부 천공지 유리피판을 이용한 하지 재건

Reconstruction of Lower Extremities using Anterolateral thigh Perforator Free Flaps

  • 김태곤 (울산대학교 의과대학 성형외과학교실) ;
  • 강민구 (성균관대학교 의과대학 성형외과학교실)
  • Kim, Tae Gon (Department of Plastic and Reconstructive Surgery, Ulsan University Hospital, University of Ulsan, College of Medicine) ;
  • Kang, Min Gu (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, School of Medicine, Sung Kyun Kwan University)
  • 투고 : 2007.10.31
  • 심사 : 2007.12.22
  • 발행 : 2007.12.30
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초록

Purpose: Management of the soft tissue defect in the lower extremity caused by trauma has always been difficult. Coverage with local and free muscle flaps after complete surgical excision of necrotic soft tissue and bone is a major strategy for treatment. There is no doubt that muscle provides a good blood supply, thus improving bone healing and increasing resistance to bacterial inoculation. However, accompanying problems are seen in cases with shallow dead space. This research was conducted to assess the efficacy of raising anterolateral thigh flaps and transferring them to the defect after complete debridement of non-viable, infected, and scar tissue as an alternative way to use local or free muscle flaps. Methods: From March 2005 to October 2007, 18 cases of soft tissue defect on lower extremities were re-surfaced with an anterolateral thigh perforator free flap. Results: The follow-up period ranged from 1 to 31 months with a mean of 15.9 months. All flaps survived completely. Satisfactory aesthetic and functional results were achieved. Under a two-point discrimination test, 13 patients had sensory recovery from 11 mm to 20 mm after 6 months postoperatively. Conclusion: Reconstruction of the lower extremity with anterolateral thigh perforator free flaps after appropriate debridement is a good alternative way to use local or free muscle flaps.

키워드

참고문헌

  1. Arnold PG, Yugueros P, Hanssen AD: Muscle flaps in osteomyelitis of the lower extremities of the lower extremity: a 20-year account. Plast Reconstr Surg 1999;104:107-10 https://doi.org/10.1097/00006534-199907000-00015
  2. Gonzalez Mh, Tarandy DI, Troy K, Phillips D, Weinzweig N: Free tissue coverage of chronic traumatic wounds of the lower leg. Plast Reconstr Surg 2002;109:592-600 https://doi.org/10.1097/00006534-200202000-00028
  3. Yildirim S, Gideroglu K, Akoz T: The simple and effective choice for treatment of chronic calcaneal osteomyelitis: neurocutaneous flaps. Plast Reconstr Surg 2003;111:753-60 https://doi.org/10.1097/01.PRS.0000041446.73584.28
  4. Weinzweig M, Davies BW: Foot and ankle reconstruction using the radial forearm flap: a review of 25 cases. Plast Reconstr Surg 1998;1999-2005:102 https://doi.org/10.1097/00006534-199811000-00029
  5. Baek SM. Two new cutaneous flaps: the medial and lateral thigh flaps. Plast Reconstr Surg 1983;71:354-63 https://doi.org/10.1097/00006534-198303000-00012
  6. Song YG, Chen CZ, Song YL. The free thigh flap: A new concept based on the septocutaneous artery. Br J Plast Surg 1984;37:149-59 https://doi.org/10.1016/0007-1226(84)90002-X
  7. Koshima I, Fukuda H, Utunomiya R, Soeda S. The anterolateral thigh flap: Variations in vascular pedicle. Br J Plast Surg 1989;42:260-2 https://doi.org/10.1016/0007-1226(89)90142-2
  8. Koshima I, Fukuda H, Yamamoto H, Moriguchi T, Soeda S, Ohta S. Free anterolateral thigh flaps for reconstruction of head and neck defects. Plast Reconstr Surg 1993;92:421-8 https://doi.org/10.1097/00006534-199309000-00005
  9. Pribaz JJ, Orgill DP, Epstein MD, Sampson CE, Hergrueter CA. Anterolateral thigh free flap. Ann Plast Surg 1995;34:585-92 https://doi.org/10.1097/00000637-199506000-00004
  10. Miller MJ, Reece GP, Marchi M, Baldwin BJ. Lateral thigh free flap in head and neck reconstruction. Plast Reconstr Surg 1995;96:334-40 https://doi.org/10.1097/00006534-199508000-00011
  11. Ha BJ, Kim HS. Reconstruction of wide and long skin defects using lateral thigh free flap 1998;25:912-20
  12. Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K. Anatomic variations and technical problems of the anterolateral thigh flap: A report of 74 cases. Plast Reconstr Surg 1998;102:1517-23 https://doi.org/10.1097/00006534-199810000-00026
  13. Luo S, Raffoul W, Luo J, Luo L, Gao J, Chen L et al. Anterolateral thigh flap: a review of 168 cases Microsurg 1999;19:232-8 https://doi.org/10.1002/(SICI)1098-2752(1999)19:5<232::AID-MICR5>3.0.CO;2-S
  14. Shieh SJ, Chiu HY, Yu JC, Pan SC Tsai ST, Shen CL. Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation. Plast Reconstr Surg 2000;105:2349-57 https://doi.org/10.1097/00006534-200006000-00006
  15. Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH. Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 2002;109:2219-26 https://doi.org/10.1097/00006534-200206000-00007
  16. Chen HC, Tang YB. Anterolateral thigh flap: an ideal soft tissue flap Clin Plastic Surg 2003;30:383-401 https://doi.org/10.1016/S0094-1298(03)00040-3
  17. Kawai K, Imanishi N, Nakajima H, Aiso S, Kakibuchi M, Hosokawa K. Vascular anatomy of the anterolateral thigh flap. Plast Reconstr Surg 2004;114:1108-17
  18. Kim JT, Lee CY, Kim SJ. Various utility of perforator flaps in head and neck reconstruction. J Korean Soc Plast Reconstr Surg 2005;32:271-80
  19. Kim EK, Hong JP. Sole reconstruction using anterolateral thigh perforator free flaps. J Korean Soc Plast Reconstr Surg 2005;32:441-6