역혈류성 전외측대퇴 혈관경 피판을 이용한 무릎 주위 결손의 재건 (Distally based anterolateral thigh pedicled flap in the reconstruction of defect around knee)

서지정보

· 발행기관 : 대한성형외과학회
· 수록지 정보 : Archives of Plastic Surgery / 37권 / 6호 / 769 ~ 774페이지
· 저자명 : 박상순, 심정수

초록

Purpose: The soft tissue defect around the knee is a difficult area to reconstruct and therefore, local flap or free flap are used. Distally based anterolateral thigh pedicled flap introduced by Zhang uses sufficient reverse flow supplied from the vascular network around the knee and we are reporting successful reconstruction of defect around knee through the use of this method.
Method: Total of 4 patients who get skin & soft tissue defect around knee have been treated to reconstruction using the distally based anterolateral thigh pedicled flap. First, the doppler was used to check for the perforator flap of the descending branch of the lateral circumflex femoral artery and to draw and dissect the perforator flap as much as needed. After the dissection, the proximal of the descending branch was clamped and checked for sufficient supply of blood flow from the reverse flow and then ligated. It was dissected along the descending branch and to prevent damage to the joined parts of the descending branch and the lateral superior geniculate artery, A more careful ligation was done starting from 10cm superior to the knee. The defect was reconstructed after securing enough vascular pedicle to cover all the damaged parts.
Results: Not all patients suffered from flap necrosis. With the patient with chronic osteomyelitis, slight venous congestion was observed right after the surgery but was not to be observed after the following day. All three patient had no occurences of additional complications.
Conclusion: Distally based anterolateral thigh pedicled flap was enough to provide large flap for knee reconstruction. It had sufficient blood flow and vascular pedicle. It also had taken short operation time compared to the free flap operation. Therefore, the distally based anterolateral thigh pedicled flap used by the authors are a very useful way of reconstructing the area around knee.

영어초록

Purpose: The soft tissue defect around the knee is a difficult area to reconstruct and therefore, local flap or free flap are used. Distally based anterolateral thigh pedicled flap introduced by Zhang uses sufficient reverse flow supplied from the vascular network around the knee and we are reporting successful reconstruction of defect around knee through the use of this method.
Method: Total of 4 patients who get skin & soft tissue defect around knee have been treated to reconstruction using the distally based anterolateral thigh pedicled flap. First, the doppler was used to check for the perforator flap of the descending branch of the lateral circumflex femoral artery and to draw and dissect the perforator flap as much as needed. After the dissection, the proximal of the descending branch was clamped and checked for sufficient supply of blood flow from the reverse flow and then ligated. It was dissected along the descending branch and to prevent damage to the joined parts of the descending branch and the lateral superior geniculate artery, A more careful ligation was done starting from 10cm superior to the knee. The defect was reconstructed after securing enough vascular pedicle to cover all the damaged parts.
Results: Not all patients suffered from flap necrosis. With the patient with chronic osteomyelitis, slight venous congestion was observed right after the surgery but was not to be observed after the following day. All three patient had no occurences of additional complications.
Conclusion: Distally based anterolateral thigh pedicled flap was enough to provide large flap for knee reconstruction. It had sufficient blood flow and vascular pedicle. It also had taken short operation time compared to the free flap operation. Therefore, the distally based anterolateral thigh pedicled flap used by the authors are a very useful way of reconstructing the area around knee.

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