Use Anterolateral Thigh Perforator Flap To Avoid Injury Of Secondary Donor Area In The Reconstruction Of Large Soft Tissue Defects

Objective:This study focus on feasibility and clinical effects of avoiding injury of secondary donor area in the reconstruction of large soft tissue defects with anterolateral thigh perforator flap,providing statistical evidence of clinical application of this surgical method and a reference for reducing injury of donor area.Methods:In this paper,the medical data of 40 patients with large soft tissue defects who were treated by anterolateral thigh flap in department of Trauma Orthopedics and Microsurgery of Guilin People’s Hospital from January 2013 to July 2021 were selected as retrospective research subjects.According to the data:22 male patients,18 female patients;the average age is39.7 years,the age range is between 24 and 61;11 cases of upper limbs and 29cases of lower limbs;the injury causes include crush injury(19 cases),twisting trauma of machine(13 cases)and fall injury(8 cases);the scope of tissue defects ranges from 11.3 cm×8.5cm to 22.5cm×17.0cm(length×width).According to the operation method,22 cases of anterolateral thigh perforator flap group(A group)and 18 cases of anterolateral thigh flap group(B group)were divided into two groups.The gender differences,area of defects,operating time,intraoperating blood loss,scar area of donor site and sensory recovery of donor area were brought into comparative analysis.Results:The follow-up period of all cases ranged from 6 months to 12 months(mean 10.0 months)and the follow-up information was integral.A group included 22 cases,the average age was 38.5 years old(age range:24～60),B group included 18 cases,the average age was 41.1 years old(age range:25～61).According to the statistical analysis,there was no statistical difference in gender between A group and B group(χ~2=1.609,P>0.05),there was statistical difference in area of defects between A group and B group(t=1.448,P<0.05),there was statistical difference in operating time between A group and B group(t=3.335,P<0.05),there was no statistical difference in intraoperating blood loss between A group and B group(t=0.376,P>0.05),there was statistical difference in scar area of donor site between A group and B group(t=-4.395,P<0.05),there was statistical difference in scar area of donor site between A group and B group(there was statistical difference in sensory recovery of donor area between A group and B group(t=-4.395,P<0.05).Conclusions:In the process of repairing large soft tissue defects,anterolateral thigh perforator flap can increase utilization efficiency of soft tissue significantly and repair larger defects comparing with traditional anterolateral thigh flap.So the donor area could be sutured directly without repair avoiding injury of secondary donor area.The scar of donor area is much more minor in long term.The sensory recovery of donor area comes better.Anterolateral thigh perforator flap can be promoted in clinical practice.