背景:多个相邻缺陷(MAD)的有效重修需要精确的重建策略。各种方法(例如,已经报道了几个皮瓣转移或接受部位的预层压),但是接收者站点损伤,疼痛,长期住院,低成本效益的结果注定会把它们视为妥协的方法。本研究旨在评估使用游离的多桨浅旋支髂动脉穿支(SCIAP)皮瓣重建MADs的可行性。
方法:从2015年12月至2020年12月,我们招募了使用各种多桨SCIAP皮瓣(2桨,3桨,和4桨)。收集各组患者的人口统计学和结果。
结果:32,21名,6名患者接受了2桨,3桨,和4桨SCIAP襟翼转移,分别。所有多桨SCIAP皮瓣均存活,没有血管问题,捐赠地点直接关闭。除3例2桨SCIAP皮瓣经旋髂浅静脉回流引流外,大多数病例(n=56)由静脉顺流引流。轻微的并发症,包括部分皮瓣坏死(4例)和股外侧皮神经麻痹(11例),被保守地对待。所有患者对重建结果均满意。
结论:多个相邻缺损重建仍然是一个难题,缺乏黄金标准。自由的多桨SCIAP皮瓣被证明是一种有希望的替代品,不仅丰富了其多功能性,而且还初步突出了“以需要取代需要”的重建需求。
BACKGROUND: The efficient resurfacing of multiple adjacent defects (MADs) requires precise reconstructive strategy. Various approaches (e.g., several flap transferring or prelamination of the recipient site) have been reported, but recipient-site impairments, pain, long hospitalization, and low cost-benefit results fatefully considered them as compromise approaches. This study aims to evaluate the feasibility of MADs reconstruction with free multipaddle superficial circumflex iliac artery perforator (SCIAP) flaps.
METHODS: From Dec 2015 to Dec 2020, we enrolled patients with upper and lower extremity defects treated with various multipaddle SCIAP flaps (2-paddle, 3-paddle, and 4-paddle). Patient demographics and outcomes of each group were collected.
RESULTS: Thirty-two, 21, and 6 patients underwent 2-paddle, 3-paddle, and 4-paddle SCIAP flaps transfers, respectively. All multipaddle SCIAP flaps survived without vascular problems, and the donor sites were closed directly. Except for 3 cases of 2-paddle SCIAP flaps drained by superficial circumflex iliac vein venous return, most cases (n = 56) were drained by venae comitans. Minor complications, including partial flap necrosis (4 cases) and lateral femoral cutaneous nerve palsies (11 cases), were treated conservatively. All patients were satisfied with the reconstructive outcome.
CONCLUSIONS: Multiple adjacent defects reconstruction is still a Gordian knot and lacks a golden standard. The free multipaddle SCIAP flap was demonstrated as a promising alternative, not only enriching its versatility but also initially highlighting the \"replace need with need\" reconstructive demand.