Free Vastus Lateralis Muscle Flap in Lower Extremity Reconstruction: Clinical Experiences

股外側肌自由肌皮瓣用於下肢重建的臨床經驗

邱智弘(Mark Chih-Hung Chiu) ； 李俊達(Jiunn-Ta Lee) ； 鄭立福(Li-Fu Cheng) ； 孫宗伯(Tzong-Bor Sun) ； 王健興(Chien-Hsin Wang) ； 許宏達(Hon-Da Shie) ； 黃介琦(Chieh-Chi Huang) ； 簡守信(Sou-Hsin Chien)

《中華民國整形外科醫學會雜誌》 13卷2期 (2004/06) Pp. 97-105

https://doi.org/10.7096/JPSA.200406.0097

摘要

自2001年12月到2003年7月，共有七位下肢缺損的病人接受股外側肌自由皮瓣的移植手術。其中一位是女姓，其餘六位為男性。缺損的致病因為：糖尿病併發症，燒傷，外傷，及惡性腫瘤切除。自由肌皮瓣用於覆蓋骨頭或肌腱露出處及足部受壓處。病人平均年齡為58.1歲（介於48歲至66歲之間）。平均追蹤時間為9個月（6個月至12個月）。七例皮瓣有一例完全壞死，六例存活。皮瓣壞死原因可能因為皮瓣血管莖阻塞病變。利用股外側肌自由肌皮瓣，六位病人免於截肢的命運，術後也皆恢復行走能力。對於下肢缺損的重建，我們認為股外側肌自由肌皮瓣是個相當不錯的選擇。與其他傳統的自由肌皮瓣比較，它具有下列優點：拿取容易，可同時兩組人進行手術，血管莖長，有足夠大的體積及低供皮瓣區的罹病率。再者，術前血管攝影及都卜勒檢查，對於皮瓣的存活扮演重要角色。

並列摘要

Free-tissue transfers have become an accepted new method of treatments in reconstruction of the lower extremity since 1972. This treatment option has profoundly influenced the fate of many salvaged limbs that in retrospect would have been amputated. From Dec 2001 to Jul 2003, seven patients with defects over the lower extremity underwent reconstructions using a free vastus lateralis muscle flap. There were six males and one female with an average age of 58.1 years (range 48 to 66 years). All flaps except one were successful without major complications. The average follow-up was 9 months (range 6 to 12 months). The six patients with established wound complications experienced complete resolution of their ability. Limb salvage was achieved in these six patients and their ambulation was restored. In comparison with other muscle flaps, we found the vastus lateralis muscle flap is an excellent option for lower extremity reconstruction due to its advantages of ease in harvesting, allowing two-team approach, relatively long vascular pedicle as well as availability of adequate muscle volume and lower donor-site morbidity. Also, preoperative angiographic or Doppler confirmation is valuable to decrease flap complication.

並列關鍵字

vastus lateralis muscle flap ； lower extremity reconstruction