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Abstract：
OBJECTIVE: To compare the clinical outcomes of anterolateral femoral interregional flap with turbocharge technique and traditional anterolateral femoral flap in repair of large limb wounds.
METHODS: Clinical data of 38 patients with large limb surface wound (11 cm×39 cm-16 cm×65 cm) admitted to the Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from May 2018 to May 2022 were retrospectively analyzed. Eighteen patients were treated by anterolateral thigh perforator flap combined with superficial circumflex iliac artery flap (ALTP-SCIAP) with turbocharge technique (interregional flap group); while 20 patients were treated with unilateral or bilateral anterolateral femoral flaps, combined with skin grafting if necessary (traditional anterolateral femoral flap group). The survival of skin flap, repair of donor area, complications and patient satisfaction were compared between the two groups.
RESULTS: In interregional flap group, 18 flaps were harvested and transplanted, the flap width, length and the viable area were (9.9±2.0) cm, (44.2±3.5) cm and (343.2±79.9) cm2, respectively. In traditional anterolateral femoral flap group, 29 flaps were harvested and transplanted, the flap width, length and the viable area were (11.0±2.8) cm, (21.7±3.2) cm and (186.4±49.2) cm2, respectively. There were significant differences in the flap length and the viable area between the two groups (t=22.365 and 8.345, both P<0.05). In the interregional flap group, the donor site of flap was closed by direct suture in 11 flaps, by skin retractor assisted suture in 6 flaps, and by skin grafting in one flap. In traditional anterolateral femoral flap group, the donor site of flap was closed by direct suture in 12 flaps, by skin retractor assisted suture in 11 flaps, and by skin grafting in 6 flaps. The skin graft rates of the two groups were 5.6% (1/18) and 20.7% (6/29), respectively (χ2=2.007, P>0.05). The interregional flap group had lower postoperative complications rate (5.6% vs. 35.0%, χ2=4.942, P<0.05) and higher patient satisfaction rate (94.4% vs. 70.0%, χ2=4.448, P<0.05) than traditional anterolateral femoral flap group.
CONCLUSIONS: Compared with the traditional anterolateral femoral flap, the anterolateral femoral interregional flap with turbocharge technique has a larger flap area, most of the donor areas of the flap can be sutured directly without skin grafting and with less complications and a higher patient satisfaction rate.
目的: 对比结合内增压技术的股前外侧跨区皮瓣与传统股前外侧皮瓣在修复肢体较大创面缺损中的临床疗效。方法: 回顾性分析2018年5月—2022年5月浙江大学医学院附属邵逸夫医院收治的肢体较大创面缺损共38例患者（缺损面积达到11 cm×39 cm~16 cm×65 cm）的临床资料。按照修复方式的不同，将患者分为跨区皮瓣修复组（18例）和传统皮瓣修复组（20例）。跨区皮瓣修复组采用结合内增压技术的股前外侧穿支皮瓣联合旋髂浅动脉皮瓣（ALTP-SCIAP）治疗，传统皮瓣修复组采用单侧或双侧股前外侧皮瓣，必要时联合植皮。比较两组术后皮瓣存活情况、供区修复情况、并发症、患者满意度等。结果: 跨区皮瓣修复组中，切取移植皮瓣18例次，瓣宽（9.9±2.0）cm，瓣长（44.2±3.5）cm，存活面积（343.2±79.9）cm2。传统皮瓣修复组中，切取移植皮瓣29例次，瓣宽（11.0±2.8）cm，瓣长（21.7±3.2）cm，存活面积（186.4±49.2）cm2。瓣长和存活面积跨区皮瓣修复组显著大于传统皮瓣修复组（t=22.365和8.345，均P<0.05）。跨区皮瓣修复组皮瓣供区采用直接缝合11例次，皮肤牵拉器辅助下缝合6例次，部分植皮修复1例次。传统皮瓣修复组皮瓣供区采用直接缝合12例次，皮肤牵拉器辅助下缝合11例次，部分植皮修复6例次。两组皮瓣供区修复的植皮率分别为5.6%（1/18）和20.7%（6/29），差异无统计学意义（χ2=2.007，P>0.05）。跨区皮瓣修复组中出现并发症1例（5.6%），患者满意度达到94.4%；而传统皮瓣修复组中出现并发症7例35.0%，患者满意度为70.0%。相比传统皮瓣修复组，跨区皮瓣修复组并发症发生率降低（χ2=4.942，P<0.05），患者满意度升高（χ2=4.448，P<0.05）。结论: 与传统股前外侧皮瓣比较，结合内增压技术的股前外侧跨区皮瓣切取面积更大，皮瓣供区大多可Ⅰ期直接缝合，不需要植皮修复，并发症更少，患者满意度更高。.
METHODS: Clinical data of 38 patients with large limb surface wound (11 cm×39 cm-16 cm×65 cm) admitted to the Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from May 2018 to May 2022 were retrospectively analyzed. Eighteen patients were treated by anterolateral thigh perforator flap combined with superficial circumflex iliac artery flap (ALTP-SCIAP) with turbocharge technique (interregional flap group); while 20 patients were treated with unilateral or bilateral anterolateral femoral flaps, combined with skin grafting if necessary (traditional anterolateral femoral flap group). The survival of skin flap, repair of donor area, complications and patient satisfaction were compared between the two groups.
RESULTS: In interregional flap group, 18 flaps were harvested and transplanted, the flap width, length and the viable area were (9.9±2.0) cm, (44.2±3.5) cm and (343.2±79.9) cm2, respectively. In traditional anterolateral femoral flap group, 29 flaps were harvested and transplanted, the flap width, length and the viable area were (11.0±2.8) cm, (21.7±3.2) cm and (186.4±49.2) cm2, respectively. There were significant differences in the flap length and the viable area between the two groups (t=22.365 and 8.345, both P<0.05). In the interregional flap group, the donor site of flap was closed by direct suture in 11 flaps, by skin retractor assisted suture in 6 flaps, and by skin grafting in one flap. In traditional anterolateral femoral flap group, the donor site of flap was closed by direct suture in 12 flaps, by skin retractor assisted suture in 11 flaps, and by skin grafting in 6 flaps. The skin graft rates of the two groups were 5.6% (1/18) and 20.7% (6/29), respectively (χ2=2.007, P>0.05). The interregional flap group had lower postoperative complications rate (5.6% vs. 35.0%, χ2=4.942, P<0.05) and higher patient satisfaction rate (94.4% vs. 70.0%, χ2=4.448, P<0.05) than traditional anterolateral femoral flap group.
CONCLUSIONS: Compared with the traditional anterolateral femoral flap, the anterolateral femoral interregional flap with turbocharge technique has a larger flap area, most of the donor areas of the flap can be sutured directly without skin grafting and with less complications and a higher patient satisfaction rate.
目的: 对比结合内增压技术的股前外侧跨区皮瓣与传统股前外侧皮瓣在修复肢体较大创面缺损中的临床疗效。方法: 回顾性分析2018年5月—2022年5月浙江大学医学院附属邵逸夫医院收治的肢体较大创面缺损共38例患者（缺损面积达到11 cm×39 cm~16 cm×65 cm）的临床资料。按照修复方式的不同，将患者分为跨区皮瓣修复组（18例）和传统皮瓣修复组（20例）。跨区皮瓣修复组采用结合内增压技术的股前外侧穿支皮瓣联合旋髂浅动脉皮瓣（ALTP-SCIAP）治疗，传统皮瓣修复组采用单侧或双侧股前外侧皮瓣，必要时联合植皮。比较两组术后皮瓣存活情况、供区修复情况、并发症、患者满意度等。结果: 跨区皮瓣修复组中，切取移植皮瓣18例次，瓣宽（9.9±2.0）cm，瓣长（44.2±3.5）cm，存活面积（343.2±79.9）cm2。传统皮瓣修复组中，切取移植皮瓣29例次，瓣宽（11.0±2.8）cm，瓣长（21.7±3.2）cm，存活面积（186.4±49.2）cm2。瓣长和存活面积跨区皮瓣修复组显著大于传统皮瓣修复组（t=22.365和8.345，均P<0.05）。跨区皮瓣修复组皮瓣供区采用直接缝合11例次，皮肤牵拉器辅助下缝合6例次，部分植皮修复1例次。传统皮瓣修复组皮瓣供区采用直接缝合12例次，皮肤牵拉器辅助下缝合11例次，部分植皮修复6例次。两组皮瓣供区修复的植皮率分别为5.6%（1/18）和20.7%（6/29），差异无统计学意义（χ2=2.007，P>0.05）。跨区皮瓣修复组中出现并发症1例（5.6%），患者满意度达到94.4%；而传统皮瓣修复组中出现并发症7例35.0%，患者满意度为70.0%。相比传统皮瓣修复组，跨区皮瓣修复组并发症发生率降低（χ2=4.942，P<0.05），患者满意度升高（χ2=4.448，P<0.05）。结论: 与传统股前外侧皮瓣比较，结合内增压技术的股前外侧跨区皮瓣切取面积更大，皮瓣供区大多可Ⅰ期直接缝合，不需要植皮修复，并发症更少，患者满意度更高。.
摘要：
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