Ning Zhang, Fei Liu, Cun Huang, Zhixue Kang, Wujun Du, Jianming Yang, Linrui Ma
{"title":"流式大腿前外侧穿孔器皮瓣在复杂断肢再植中的应用","authors":"Ning Zhang, Fei Liu, Cun Huang, Zhixue Kang, Wujun Du, Jianming Yang, Linrui Ma","doi":"10.1016/j.transproceed.2024.08.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To explore the clinical application value of flow-through anterolateral thigh perforator (ALTP) flaps in replantation of complex severed limbs.</p></div><div><h3>Methods</h3><p>Thirteen severe vascular, nerve injury, and skin or soft tissue defects in patients with complex severed limbs from August 2017 to January 2019 were enrolled in this retrospective study. The skin flap has covered the wound by using the flow-through ALTP flap technique. The main vascular defect was repaired by using the descending branch of the lateral circumflex femoral artery, and the blood supply of the transplanted limb was reconstructed. The blood supply of the flap and wound healing observed were observed after the operation. Regular follow-up was performed to observe the survival and functional recovery of the replanted limb.</p></div><div><h3>Results</h3><p>Eleven cases of replanted limb and perforator flap survived completely. Limb shortening occurred in 3 patients owing to bone defects caused by distal amputation. After the second stage of bone transplantation, the limb length and function of those 3 patients recovered well. One case showed necrosis of the little finger after replantation of the severed palm. One case showed that the crushed forearm was severed completely. The anastomotic vascular inflammatory embolism was caused by infection and necrosis of soft tissue after replantation for 2 weeks, and then the stump wound was covered with a survived skin flap in the second stage.</p></div><div><h3>Conclusion</h3><p>The flow-through ALTP flap technique has a good therapeutic effect on the functional reconstruction of complex severed limbs with severe skin and vascular injuries.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Application of Flow-through Anterolateral Thigh Perforator Flaps in Replantation of Complex Severed Limb\",\"authors\":\"Ning Zhang, Fei Liu, Cun Huang, Zhixue Kang, Wujun Du, Jianming Yang, Linrui Ma\",\"doi\":\"10.1016/j.transproceed.2024.08.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To explore the clinical application value of flow-through anterolateral thigh perforator (ALTP) flaps in replantation of complex severed limbs.</p></div><div><h3>Methods</h3><p>Thirteen severe vascular, nerve injury, and skin or soft tissue defects in patients with complex severed limbs from August 2017 to January 2019 were enrolled in this retrospective study. The skin flap has covered the wound by using the flow-through ALTP flap technique. The main vascular defect was repaired by using the descending branch of the lateral circumflex femoral artery, and the blood supply of the transplanted limb was reconstructed. The blood supply of the flap and wound healing observed were observed after the operation. Regular follow-up was performed to observe the survival and functional recovery of the replanted limb.</p></div><div><h3>Results</h3><p>Eleven cases of replanted limb and perforator flap survived completely. Limb shortening occurred in 3 patients owing to bone defects caused by distal amputation. After the second stage of bone transplantation, the limb length and function of those 3 patients recovered well. One case showed necrosis of the little finger after replantation of the severed palm. One case showed that the crushed forearm was severed completely. The anastomotic vascular inflammatory embolism was caused by infection and necrosis of soft tissue after replantation for 2 weeks, and then the stump wound was covered with a survived skin flap in the second stage.</p></div><div><h3>Conclusion</h3><p>The flow-through ALTP flap technique has a good therapeutic effect on the functional reconstruction of complex severed limbs with severe skin and vascular injuries.</p></div>\",\"PeriodicalId\":23246,\"journal\":{\"name\":\"Transplantation proceedings\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation proceedings\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S004113452400424X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S004113452400424X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Application of Flow-through Anterolateral Thigh Perforator Flaps in Replantation of Complex Severed Limb
Objective
To explore the clinical application value of flow-through anterolateral thigh perforator (ALTP) flaps in replantation of complex severed limbs.
Methods
Thirteen severe vascular, nerve injury, and skin or soft tissue defects in patients with complex severed limbs from August 2017 to January 2019 were enrolled in this retrospective study. The skin flap has covered the wound by using the flow-through ALTP flap technique. The main vascular defect was repaired by using the descending branch of the lateral circumflex femoral artery, and the blood supply of the transplanted limb was reconstructed. The blood supply of the flap and wound healing observed were observed after the operation. Regular follow-up was performed to observe the survival and functional recovery of the replanted limb.
Results
Eleven cases of replanted limb and perforator flap survived completely. Limb shortening occurred in 3 patients owing to bone defects caused by distal amputation. After the second stage of bone transplantation, the limb length and function of those 3 patients recovered well. One case showed necrosis of the little finger after replantation of the severed palm. One case showed that the crushed forearm was severed completely. The anastomotic vascular inflammatory embolism was caused by infection and necrosis of soft tissue after replantation for 2 weeks, and then the stump wound was covered with a survived skin flap in the second stage.
Conclusion
The flow-through ALTP flap technique has a good therapeutic effect on the functional reconstruction of complex severed limbs with severe skin and vascular injuries.
期刊介绍:
Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication.
The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics.
Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board.
Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.