| Objective: We can often receive some patients which belong to Gustilo-Anderson III-IV in our daily life,and these patients injury severely.They usually has a very large wound in which the soft tissue is damaged seriously,and What is more serious is that the main Blood vessels or nerves may be damaged.they would probably be infected or even be amputation because there is no better way to treat before.Therefore,we consider it necessary to summarize all of crural anterolateral skin flap,combining with the experience of clinical research in past time.To summarize the characteristics and applicable of various crural anterolateral skin flap,according to analyzing the different crural anterolateral skin flap which used to cure the different patients after severe injury.Methods: We retrospectively analyze the clinical data and treatment of 92 patients which used crural anterolateral skin flap to cover the defective area such as ankle foot hand and so on.67 patients chosen pedicle skin flap to cure their disease.20 patients chosen free skin flap to cure their disease.5 patients chosen cross leg skin flap to cure their disease.Then we respectively describe various operative procedure,and analysis various operative results in detail.There are 54 patients could chosen these treatment that the flap sutured with a cutaneous nerve of receptivesite,38 case of these patients did,others did not.Compared with the two groups patients of the sensory recovery of the skin flap after operation.And then use these data for statistical analysis.Statistical data inspection using chi square test.Results: In this study,136 cases of patients with various types of wounds,all take the crus of the lateral skin flap to repair the defect,and achieved good clinical efficacy.The use of local skin flap in 67 cases of wound repair adjacent,using free flap to repair the wound with a total of 20 cases.In order to use the bridge flap contralateral anterior tibial artery as the pedicle graft anastomosis of lateral free skin flap to cover the wound in 5 cases.81 cases of flaps in patients with a survival,accounting for 88.06%,7 cases of patients with the distal end of the flap or flap edge necrosis,healed after enhanced dressing,or skin grafting of reoperation after,7.6%,4 cases of patients of the flap edge slight infection,4.35%.Among the cases,24 cases had protective sensation after operation,and the recovery rate was 63.2%.The postoperative protective sensation was 18.8%.85 patients were followed up for 3 to November years.The appearance and texture of the flaps were good.Conclusions:(1)the partial transfer of the pedicle flap of the anterior leg of the leg can be used to repair most of the wound surface.(2)free micro peroneal artery perforator flap and superficial peroneal artery flap can be used for precise repair of skin defect in hand and foot,not only provided a small and repairing effect than the general operation better.(3)the rate of postoperative sensory recovery was significantly higher than that of the skin flap with no anastomosis.(4)if severe trauma.First,suffer from limb does not have enough normal tissue,the second no agreement with the blood vessels,and large wound,health limb also not enough to transfer the normal soft tissue,but the main blood vessels normal variation,in order to salvage,can consider the use of cross bridge flap side were mainly vascular bridge kissing free flap to repair the wound. |
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