PDF(Pubmed)
Abstract：
This study aimed to analyze cases of anterolateral thigh (ALT) free flap used for hand reconstruction with terminal perforator-to-digital artery anastomosis. Patients who underwent ALT free flap placement with terminal perforator-to-digital artery anastomosis for hand reconstruction between January 2011 and August 2021 were included. The number, length, and diameter of the perforators and veins, flap size, and operative time were investigated through a retrospective review of charts and photographs. The occurrences of arterial thrombosis, venous thrombosis, arterial spasm, and flap necrosis were analyzed. In total, 50 patients were included in this study. The mean diameter and length of the perforators were 0.68 mm and 3.25 cm, respectively, and the mean number of veins anastomosed was 1.88, with a mean diameter of 0.54 mm. Complications included four cases of arterial thrombosis, one case of venous thrombosis, seven cases of partial necrosis, and one case of total flap failure. Regression analysis showed that a longer perforator was associated with arterial thrombosis whereas larger flap size and number of anastomosed veins were associated with partial necrosis ( p < 0.05). The terminal perforator-to-digital artery anastomosis offers advantages in using compact free flaps with short pedicle lengths to cover small hand defects.
摘要：
本研究旨在分析股前外侧（ALT）游离皮瓣用于末端穿支至指动脉吻合术的手部重建的病例。包括在2011年1月至2021年8月之间进行ALT游离皮瓣放置并进行末端穿支至指动脉吻合以进行手部重建的患者。数字,长度,穿孔器和静脉的直径，皮瓣尺寸,和手术时间通过回顾性图表和照片进行调查。动脉血栓形成的发生，静脉血栓形成,动脉痉挛,并对皮瓣坏死进行分析。总的来说,本研究包括50名患者。穿孔器的平均直径和长度分别为0.68mm和3.25cm，分别,平均吻合静脉数为1.88，平均直径为0.54mm。并发症包括动脉血栓形成4例，一例静脉血栓形成,部分坏死7例,和一例襟翼完全失效。回归分析显示，较长的穿支与动脉血栓形成有关，而较大的皮瓣大小和吻合静脉数量与部分坏死有关（p<0.05）。末端穿支至指动脉吻合术在使用具有短椎弓根长度的紧凑自由皮瓣覆盖小的手部缺损方面具有优势。
