Versatility of the Anterolateral Thigh Perforator Flap

前外股皮瓣早在1984年由大陸宋醫師提出，但因爲血管莖的走向變異性大，一直沒有被普遍使用，之後日本Koshima醫師、台灣魏醫師、邱醫師、謝醫師對血管變異性提出更深入的探討，也使這個皮瓣的可用性大為提昇。由於過去傳統游離皮瓣，包括前臂橈動脈、股薄肌皮瓣等，當我們在處理各種較大缺損或所須組織較多樣化時，常常捉襟見肘，使手術結果打折扣，而前外股穿通枝皮瓣，雖然解剖上有變異性，但由於手術熟稔性增加已經可以克服。它的優點包括血管莖大小及長度都很好，可以提供大面積的皮瓣，並因應傷口的需要可以附帶肌肉，神經骨頭等組織，並有可以兩組手術同時進行縮短手術時間等優點，從2000至2002，我們有7個病人使用這個皮瓣來重建各種不同類型的傷口，結果滿意，因此我們認為外股穿通枝皮瓣是一個值得考慮的多用途性皮瓣。

關鍵字

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並列摘要

Seven patients underwent soft tissue reconstruction with free anterolateral thigh (ALT) flaps including six fasciocutaneous and one musculocutaneous flap associated with the vastus lateralis (VL). Four patients underwent the reconstruction for coverage of head and neck defects, including two with buccal cancer, one with tongue cancer, and one with extensive facial burn scars. Two patients required lower extremity reconstruction, including one with a chronic diabetic foot ulcer and the other with a crush injury resulting in tendon exposure in the dorsum of the right foot. The seventh patient had chronic sternal osteomyelitis after coronary artery bypass graft. All flaps survived without complications. Three donor sites were closed primarily and the other four larger defects with skin grafts. Morbidity at the donor sites was limited and acceptable after six months of follow up. According to our experience, the anterolateral thigh flap based on perforators of the descending branch of the lateral circumflex fem oral artery is a reliable and versatile flap. It can be used in almost any composite defect without difficulty.

並列關鍵字

anterolateral thigh (ALT) flap ； vastus lateralis (VL) lateral circumflex femoral artery (LCFA)

國際替代計量

Versatility of the Anterolateral Thigh Perforator Flap

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