Abstract:
Objective To investigate the influence of the location of the perforator branch and the route of the perforator branch through the deep fascia on the partial necrosis of the anterolateral thigh flap.
Methods A retrospective study was conducted on 25 patients with partial necrosis of skin flap after limb wound repair with free anterolateral thigh flap at the Department of Hand Surgery, Suzhou Ruihua Orthopaedic Hospital from October 2018 to June 2021. At the same time, 25 patients with no necrosis of anterolateral thigh flap were randomly selected. The age, sex, the type of perforator, the distance between the perforator and the edge of the skin, the consistency between the design of the position of the perforator branch and the pattern of the perforator branch after penetrating the deep fascia, the cutting time of the flap and the size of flap were compared and analyzed between the two groups. Data were analyzed by t-test, chi-square test and logistic regression analysis.
Results There was no significant difference in age, sex, type of perforator, distance from perforator to skin margin, flap removal time and flap size between the two groups (P>0.05). There was a significant difference in the number of cases in which the location of the perforator branch was consistent with the direction of the deep fascia of the perforator branch between the two groups (P=0.001). Logistic regression analysis showed that whether the location design of the perforator branch was consistent with the route of the perforator branch after penetrator the deep fascia was the influencing factor of partial necrosis of the skin flap (OR=38.812, P<0.001).
Conclusion Whether the design of the position of the perforator branch is consistent with the way of the perforator branch after penetrator the deep fascia is the reason that affects the partial necrosis of the skin flap. The probability of partial necrosis of the flap can be reduced by designing the flap according to the ascending mode of the perforator branch after penetracting the deep fascia and the position of the perforator branch.
Key words:
Perforator flap,
Anterolateral thigh flap,
Partial necrosis,
Skin insertion mode,
Skin flap design
Qinfeng Gao, Lin Yang, Yongtao Huang, Chengpeng Yang, Fengwen Sun, Yang Cao, Yucheng Liu, Yan Zhang, Junnan Cheng, Tao Zhang, Jihui Ju. A preliminary study on the effect of the location of the perforator branch and the route of the perforator branch through the deep fascia on the partial necrosis of the anterolateral thigh flap[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(02): 141-146.