Using the Free Vastus Lateralis Musculocutaneous or Muscle Flap for Soft Tissue Defect of Lower Extremities

對於下肢遠端及足部之軟組織覆蓋是個困難的工作，游離股外側表皮肌肉皮瓣及肌肉皮瓣有較長血源蒂可提供，外觀及功能上需要。本院共有8例病患使用此皮瓣，3例男性，5例女性。其病因皆為開放性骨折後感染併組織組織缺損，以部位分佈而言，在下肢遠端部6例，在足跟部1例，在足部1例。使用表皮肌肉皮瓣有3例，肌肉皮瓣加植皮有5例。皮瓣大小由15x7至30x15公分。供給區直接縫合有4例，植皮有4例。術後使用AO外固定桿架腳，以使患肢抬高，促進回流，方便換藥。所有皮瓣完全存活，有一例因皮瓣滯血而接受靜脈重接手術。我們認為這是個穩定容易取得皮瓣，不須改變姿勢，低供給區問題，對下肢及足部中至大範圍傷口，特別是有骨外露感染時，提供組織缺損重建另一不錯的選擇。

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並列摘要

The coverage of the soft-tissue on the lower third of the leg has always been a difficult problem to tackle when the wound developed infected bone exposure. Free vastus lateralis musculocutaneous (VLMC) or vastus lateralis muscle (VLM) flap provided long pedicle, large size and infection tolerance. It is easy to harvest comparing with other free muscle flap. We had used this flap in eight patients. Of these, three were males and five females. The flap reconstruction was all used in trauma with open fracture patients. In six cases the defect was located in the distal third of lower leg, one over the heel, and one in the foot. The VLMC flap was applied in 3 cases; VLM flap with skin grafting was used in 5 cases. The size of the flap varied from 15 x 7cm to 30 x 15cm. There were four cases in the donor site with primary closure and four cases with skin grafting. An AO external fixation rod stand was applied to keep limb elevated. All flaps have survived completely. One case received emergency salvage operation due to flap congestion. No recurrence of osteomyelitis was noted. This series had demonstrated that free VLMC flap or VLM flap with skin grafting provided a reliable and easy practical modality, as well as versatility and low donor-site morbidity, for reconstruction of medium to large defects of the lower extremities.

並列關鍵字

free vastus lateralis musculocutaneous flap ； muscle flap ； osteomyelitis

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Using the Free Vastus Lateralis Musculocutaneous or Muscle Flap for Soft Tissue Defect of Lower Extremities

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