CAJ | 학술논문

目的探讨多个同源穿支血管为蒂的分叶型穿支皮瓣游离移植修复四肢不规则软组织缺损的临床疗效. 方法 2009年9月至2012年12月,我科采用吻合一组血管的分叶型穿支皮瓣游离移植修复四肢不规则创面15例.其中,股前外侧分叶穿支皮瓣10例、骨间后动脉分叶穿支皮瓣3例、腓肠内侧动脉分叶穿支皮瓣2例；双叶型皮瓣12例,三叶型皮瓣3例；皮瓣单叶切取面积2.5 cm×2.0 cm～15 cm×8.0 cm.所有皮瓣供区创面均一期缝合关闭. 结果 13例皮瓣顺利成活,2例各有一叶皮瓣部分坏死,经二期植皮可覆盖残留创面.术后随访3～15个月,皮瓣面积无明显回缩,色泽与受区相似,供区瘢痕挛缩不明显. 结论由同一源血管供养的分叶型穿支皮瓣血供可靠,能一次性覆盖肢体相邻的多个创面；同时,通过皮瓣各叶间的不同组合,它又能把长条状皮瓣变为各种形状,特别适合于四肢不规则创面的修复重建.
목적 탐토다개동원천지혈관위체적분협형천지피판유리이식수복사지불규칙연조직결손적림상료효. 방법 2009년9월지2012년12월,아과채용문합일조혈관적분협형천지피판유리이식수복사지불규칙창면15례.기중,고전외측분협천지피판10례、골간후동맥분협천지피판3례、비장내측동맥분협천지피판2례；쌍협형피판12례,삼협형피판3례；피판단협절취면적2.5 cm×2.0 cm～15 cm×8.0 cm.소유피판공구창면균일기봉합관폐. 결과 13례피판순리성활,2례각유일협피판부분배사,경이기식피가복개잔류창면.술후수방3～15개월,피판면적무명현회축,색택여수구상사,공구반흔련축불명현. 결론 유동일원혈관공양적분협형천지피판혈공가고,능일차성복개지체상린적다개창면；동시,통과피판각협간적불동조합,타우능파장조상피판변위각충형상,특별괄합우사지불규칙창면적수복중건.
Objective To investigate the clinical results of repairing the complicated soft tissue defects in limbs with the polyfoliate perforator flaps whose perforator vessels were all raised from the same source atrery.Methods Between September 2009 and December 2012,fifteen soft tissue defects with irregular shape were repaired with the free polyfoliate perforator flaps.There were 12 bifoliate perforator flaps and 3 trifoliate flaps in this series,and also it included 10 polyfoliate anterolateral thigh perforator flaps (PALTP),three polyfoliate posterior interosseous artery perforator flaps (PPIAP) and 2 polyfoliate medial sural artery perforator flaps(PMSAP).The sizes of unifoliate flaps ranged 2.5 cm × 2.0 cm-15.0 cm × 8.0 cm.All the wounds of donor site were closed primarily.Results All flaps survived except partial necrosis of unifoliate flap in two patients,which were repaired by skin graft finally.The clinical results were satisfactory after 3-15 months of following-up,and the scars of the donor site were not obvious.Conclusion The longitudinal flap can be changed into a variety of shapes based on the combination of the polyfoliate flaps.The free polyfoliate perforator flap has a constantly,reliable blood supply.It is a good option for repairing the soft-tissue defect with irregular shapes in the limb.