摘要
目的结合文献探讨带蒂股前外侧穿支皮瓣移植术修复臀部硬纤维瘤切除后皮肤软组织缺损的疗效。方法回顾性分析湖南省儿童医院骨科2020年11月收治的1例臀部硬纤维瘤患儿临床资料,收集肿块情况以及肿块切除后皮肤软组织缺损大小、带蒂股前外侧穿支皮瓣修复后皮瓣存活情况以及髋关节功能。以"pedicled anterolateral perforator thigh flap"、"soft tissue defect of hip"为检索词,检索PubMed数据库相关英文文献;以"带蒂股前外侧皮瓣"、"臀部皮肤软组织缺损"为检索词,检索中国知网、万方数据库中相关中文文献;检索时间自1970年1月至2022年12月,排除综述、信件、会议摘要后进行文献复习。结果本例患儿臀部硬纤维瘤大小15 cm×8 cm×6 cm,手术后臀部皮肤软组织缺损大小15 cm×6.5 cm,切取带蒂股前外侧穿支皮瓣大小15 cm×6.5 cm,采取供区直接缝合,受区无需植皮,术后皮瓣存活,未见血管危象;出院后随访24个月,臀部硬纤维瘤未见复发,供区愈合良好;无肌疝,受区皮瓣颜色、质地良好,患肢髋、膝关节活动未见受限。共检索到符合纳入标准的文献2篇,均为个案报道,共2例带蒂股前外侧穿支皮瓣移植修复臀部软组织缺损,均为男性,1例采用双侧带蒂股前外侧穿支皮瓣移植,皮瓣大小分别为35 cm×8 cm和22 cm×7 cm;另外1例切取大小29 cm×20 cm,受区部分植皮;2例术后随访皮瓣均存活,皮瓣质地良好,未见髋关节活动受限。结论带蒂股前外侧穿支皮瓣移植修复臀部皮肤软组织缺损是一种有效、可行的治疗方法。
Objective To explore the outcomes of transplanting pedicled anterolateral femoral perforator flap for repairing skin and soft tissue defect after an excision of hip dermal fibroma.Methods The relevant clinical data were retrospectively reviewed for a child hospitalized with dermol fibroma of hip in November 2020.Mass status,size of skin and soft tissue defect after mass resection,survival status of pedicled anterolateral femoral perforator flap and hip joint function were recorded."Pedicled anterolateral perforator thigh flap"and"soft tissue defect of hip"were employed as keywords for searching the relevant literatures in the databases of PubMed,China National Knowledge Infrastructure(CNKI)and WanFang from January 1970 to December 2022.Reviews,letters,conference abstracts or literatures from the same data source were excluded.Results Hip dermal fibroma was resected with a mass size of 15 cm×8 cm×6 cm,a defect size of hip skin soft tissue 15 cm×6.5 cm and a size of pedicled anterolateral perforator thigh flap 15 cm×6.5 cm.Donor area was sutured directly while recipient area required no skin grafting.No postoperative vascular crisis occurred in flap.All flaps survived during a follow-up period of 24 months.Healing of donor area was excellent with decent color/texture of recipient area flap.There was no recurrence of desmofibroma,muscular hernia or restricted hip/knee movement of affected limb.Two case reports fulfilling the inclusion criteria were retrieved.Two male cases of pedicled anterolateral femoral perforator flap were transplanted for repairing soft tissue defects involving buttock.One child was transplanted with bilateral pedicled anterolateral femoral perforator flap with sizes of 35 cm×8 cm and 22 cm×7 cm respectively.In another child,a size of 29 cm×20 cm was sliced and recipient area was partially grafted.All flaps survived during postoperative follow-ups with decent texture and no restricted movement of hip joint.Conclusions Transplanting of pedicled anterolateral perforator flap of thigh is both feasible and efficacious for repairing the defect of hip skin and soft tissue in children.
作者
王军
曾凌嵘
伍江雁
谭晓谦
梅海波
Wang Jun;Zeng Lingrong;Wu Jiangyan;Tan Xiaoqian;Mei Haibo(The Affiliated Children's Hospital Of Xiangya School of Medicine,Central South University(Hunan children's hospital),Hunan Provincial Key Laboratory of Pediatric Orthopedics,The school of pediatrics,University of South China,Changsha 410007,China)
出处
《临床小儿外科杂志》
CAS
CSCD
北大核心
2024年第3期273-278,共6页
Journal of Clinical Pediatric Surgery
基金
儿童骨科学湖南省重点实验室开放课题(2023TP1019)
芙蓉实验室科技项目(2023SK2111)
湖南省儿童肢体畸形临床医学研究中心(2019SK4006)
关键词
硬纤维瘤
带蒂股前外侧皮瓣
皮瓣转位
外科手术
儿童
Desmoid Tumors
Pedicled Anterolateral Thigh Flap
Transposition Flap
Surgical Procedures,Operative
Child
作者简介
通信作者:梅海波,Email:meihaibo@sohu.com.
