探讨应用携带阔筋膜的股前外侧皮瓣修复腹壁感染补片去除术后复杂腹壁缺损的临床效果。

选取2020年4月至2023年4月解放军联勤保障部队第九八八医院烧伤整形外科收治的7例腹壁感染补片去除术后导致的复杂腹壁缺损病例，其中男4例，女3例，年龄38~66岁；4例腹壁切口疝补片外露感染，3例因腹部肿瘤切除行补片修复术后补片外露感染。所有病例入院后，经扩创、负压封闭引流后形成深达腹膜的腹壁缺损深腔创面，创面面积为10 cm×6 cm~15 cm×10 cm，肌腱膜缺损面积为3 cm×3 cm~7 cm×5 cm；设计并切取携带阔筋膜的股前外侧皮瓣，皮瓣面积为10 cm×6 cm~15 cm×10 cm，阔筋膜面积为4 cm×3 cm~8 cm×6 cm。采用阔筋膜修复腹壁肌腱膜组织缺损，采用皮瓣修复皮肤软组织缺损。供瓣区直接拉拢缝合或移植腹部中厚皮片修复。术后观察皮瓣成活情况，供受区伤口愈合情况。随访观察皮瓣情况、腹部外形以及是否出现腹壁疝及股四头肌肌疝等。

7例患者皮瓣血运良好并顺利成活。6例患者受区创面顺利愈合，1例患者受区创面后期出现渗出，经再次扩创、缝合后愈合。7例患者供区创面均愈合。术后随访12~18个月，患者皮瓣稍臃肿，腹部外观良好，均未出现腹壁疝及股四头肌肌疝，治疗结果均满意。

携带阔筋膜的股前外侧皮瓣能加强腹壁，可良好修复腹壁感染补片去除术后导致的复杂腹壁缺损，防止术后腹壁疝及股四头肌肌疝形成。

To explore the clinical effect of anterolateral thigh flap with fascia lata in repairing complex abdominal wall defects after removal of infected abdominal mesh.

From April 2020 to April 2023， 7 patients with complex abdominal wall defects caused by removal of abdominal infected mesh in Department of Burns and Plastic Surgery，988th Hospital of Joint Logistics Support Force of PLA were selected， including 4 males and 3 females， aged 38~66 years. There were 4 cases of abdominal hernia mesh exposure infection， and 3 cases of mesh exposure infection after abdominal tumor resection and patch repair. After admission， the deep cavity wound with abdominal wall defect extending to the peritoneum was formed after debridement and vacuum sealing drainage. The wound area was 10 cm×6 cm~15 cm×10 cm， and the aponeurosis defect area was 3 cm×3 cm~7 cm×5 cm. The anterolateral thigh flap with fascia lata was designed and cut. The flap area was 10 cm×6 cm~15 cm×10 cm， and the fascia lata area was 4 cm×3 cm~8 cm×6 cm. The fascia lata was used to repair the abdominal wall aponeurosis tissue defect， and the flap was used to repair the skin and soft tissue defect. The donor site was directly sutured or grafted with abdominal medium thickness skin graft. The survival of the flap and the wound healing in the donor recipient area were observed after operation. Follow up to observe the condition of skin flap， abdominal shape， abdominal wall hernia and quadriceps hernia.

The flap blood circulation of 7 patients was good and survived smoothly. 6 patients' wounds in the recipient area healed smoothly， and 1 patient's wounds in the recipient area appeared exudation in the late stage， and healed after wound expansion and suture. All donor site wounds healed of 7 patients. The patients were followed up for 12-18 months. The flaps were slightly bloated， and the appearance of the abdomen was good. There were no abdominal wall hernia and quadriceps hernia. The treatment results were satisfactory.

The anterolateral thigh flap with fascia lata can strengthen the abdominal wall， repair the complex abdominal wall defect caused by the removal of abdominal hernia infection patch， and prevent the formation of postoperative abdominal wall hernia and quadriceps hernia.