CAJ | 학술논문

目的：探讨穿支皮瓣在下肢创面修复中的应用价值。方法计算机检索 PubMed、EMbase、中国知网以及Cochrane数据库于1980年1月—2014年4月期间公开发表的应用穿支皮瓣治疗下肢创面的文献，语种限定为中文和英文。经筛选有264篇文献入选。对皮瓣的安全性、解剖学基础及优缺点进行分析总结。结果目前应用于下肢创面修复的穿支皮瓣主要有股前外侧皮瓣、腹壁下深动脉穿支皮瓣、胸背动脉穿支皮瓣、臀动脉穿支皮瓣以及小腿穿支皮瓣等。不同皮瓣各有其特点，临床应根据其特点和创面修复要求选择合适的穿支皮瓣。结论穿支皮瓣损伤小，供区并发症低，血运丰富可靠，具有与肌皮瓣同样的抗感染能力，是下肢创面修复的新技术，也是今后皮瓣外科发展的新方向。
목적：탐토천지피판재하지창면수복중적응용개치。방법계산궤검색 PubMed、EMbase、중국지망이급Cochrane수거고우1980년1월—2014년4월기간공개발표적응용천지피판치료하지창면적문헌，어충한정위중문화영문。경사선유264편문헌입선。대피판적안전성、해부학기출급우결점진행분석총결。결과목전응용우하지창면수복적천지피판주요유고전외측피판、복벽하심동맥천지피판、흉배동맥천지피판、둔동맥천지피판이급소퇴천지피판등。불동피판각유기특점，림상응근거기특점화창면수복요구선택합괄적천지피판。결론천지피판손상소，공구병발증저，혈운봉부가고，구유여기피판동양적항감염능력，시하지창면수복적신기술，야시금후피판외과발전적신방향。
Objective To review the progress in reconstruction of lower extremity soft-tissue defects using perforator flaps. Methods Articles about perforator flaps using for the lower-limb wound reconstruction from January 1980 to April 2014 from databases such as PubMed, EMbase, CNKI and Cochrane Library were manually searched. The 264 articles were selected after they were inspected by the excluded and included standards. The safety, anatomical basis, advantages and disadvantages for the flaps were analysed. Results Perforator flaps, like musculocutaneous flaps, have a direct axial blood supply, and are just as effective as muscle flaps in the setting of radiation, hardware infection, or osteomyelitis. The major perforator flaps for the lower extremity reconstruction including anterolateral thigh flap, deep inferior epigastric perforator flap, thoracodorsal artery perforator flap, gluteal artery perforator flap and lower leg perforator flap. All these perforator flaps have each advantage, and can be selected according to the defect feature and the requirement of reconstruction. Conclusions Reconstruction the lower extremity soft-tissue defect using perforator flap is an effective method with low donor site morbidity. It is a new technology for lower extremity soft-tissue defect reconstruction, and the newest trend of development in flap surgery.