Pedicled Anterolateral Thigh Flap for the Reconstruction of Trunk and Perineum Soft Tissue Defects

軀幹及會陰軟組織缺損使用大腿前外側根蒂皮瓣重建成果及追蹤

廖紘緯(Hung-Wei Liao) ； 歐聖運(Sheng-Yun Ou) ； 董光義(Kwang-Yi Tung) ； 黃文成(Wen-Chen Huang) ； 游家孟(Chia-Meng Yu) ； 蔡明峰(Ming-Feng Tsai) ； 陳昱帆(Yu-Fan Chen) ； 姚文騰(Wen-Teng Yao)

《臺灣整形外科醫學會雜誌》 28卷4期 (2019/12) Pp. 267-278

摘要

Background: Trunk and perineum soft tissue defects may result from trauma, tumor resection, or infection, and management of these defects poses a significant challenge. The pedicled anterolateral thigh (ALT) flap is more reliable than the free ALT flap and local regional flap, has a good arc of rotation, and can be harvested as a fasciocutaneous flap with or without muscle, depending on the local anatomy and reconstructive requirements. Aim and Objectives: We present our experience of pedicled ALT flaps for the reconstruction of trunk and perineum soft tissue defects. Materials and Methods: From December 2008 to December 2018, 15 patients (8 men and 7 women) received pedicled ALT flaps for complex trunk and perineum reconstructions. The etiology of trunk and perineum soft tissue defects included benign disease, local advanced cancer, or metastatic cancer involving the trunk or perineum. Results: In total, 11 patients (73.3%) received tumor excision with oncosurgical defect , 2 patients being diagnosis of Fournier gangrene, one patient had refractory enterocutaneous fistula, one patient had recurrent ischial pressure sores were included. The average size of the pedicled ALT flap was 178.5 cm^2 (maximum: 480 cm^2). The most frequent reconstruction region was the abdominal wall (9 patients, 60%). The longest length of pedicle was 25 cm, and there was no flap loss in any of the surgeries. Postoperative complications, including wound infection and wound poor healing, were noted in two cases (13.3%). Conclusion: The pedicled ALT flap is a safe procedure, without major complication, for the reconstruction of trunk and perineum soft tissue defects.

關鍵字

pedicled anterolateral thigh flap ； trunk soft tissue defect ； perineum soft tissue defect

並列摘要

背景：軀幹及會陰軟組織缺損常因為創傷、腫瘤切除以及感染。大腿前外側根蒂皮瓣可以根據缺損的特性需求有不同的設計，皮瓣併發症也較少。目的及目標：整理過去治療經驗的病患資料，了解軀幹及會陰軟組織缺損使用大腿前外側根蒂皮瓣重建治療的成果。材料及方法：從2008年12月到2018年12月總共15位病患，包括8位男性及7位女性。軀幹及會陰軟組織缺損原因包括感染清瘡、原發癌症切除以及轉移癌症切除。結果：15位病患中有11位（73.3%）接受癌症腫瘤切除，接受軟組織缺陷重建。平均皮瓣皮膚大小178.5平方公分（最大480平方公分）。最常處理的缺損區域是腹部缺損重建，總共9位病患（60%）。術後沒有皮瓣失敗發生。術後併發症兩位（13.3%）。結論：軀幹及會陰軟組織缺損使用大腿前外側根蒂皮瓣是一個併發症低的好選擇，不管在外觀以及功能上。