腹壁下动脉穿支皮瓣修复大面积阴囊撕脱伤

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目的:探讨腹壁下动脉穿支(DIEP)皮瓣在阴囊撕脱伤修复中的应用,为大面积阴囊皮肤撕脱伤的修复提供借鉴。方法:回顾分析2010年10月至2016年12月空军军医大学西京医院5例大面积阴囊皮肤软组织撕脱伤患者的资料,患者年龄3~24岁,平均14.6岁,阴囊及邻近组织缺损面积11 cm×6 cm~25 cm×12 cm。5例患者均采用修薄的DIEP皮瓣修复阴囊部皮肤软组织撕脱伤。术后观察皮瓣成活情况及对损伤区域外观、功能重建情况,并对并发症和患者满意度进行随访。结果:术后皮瓣血运良好,供受区未发生腹壁疝、血肿、感染等并发症。随访12~24个月,其中4例移植皮瓣外观、功能恢复良好,患者满意度高;1例术后皮瓣臃肿,行去脂手术后外观改善。术后半年皮瓣感觉部分恢复。结论:修薄的DIEP皮瓣可为阴囊皮肤撕脱伤的修复提供充足的组织量,转移皮瓣血运丰富、抗感染能力强,对阴囊内容物起到一定的保护,可作为阴囊撕脱伤后皮肤软组织重建的选择之一。“,”Objective:To explore the applications of deep inferior epigastric artery perforator (DIEP) flaps in the repair of scrotal avulsions and provide the reference for reconstructions of large soft tissue defects in the scrotum.Methods:The reconstructions of five cases in large scrotal skin and soft tissue avulsion injuries by DIEP flaps in Xijing Hospital, Air Force Medical University from October 2010 to December 2016 were retrospectively analyzed and summarized. The patients were 3 to 24 years old with an average age of 14.6. The defects of the scrotum and adjacent areas were ranged from 11 cm×6 cm to 25 cm×12 cm.Results:Blood supplies of all transferred flaps were good, and there was no serious complication observed, such as abdominal hernia, hematoma, and infection in the donor or recipient sites. Patients were followed up for 12 to 24 months. The scrotum’s appearances and functions in four cases were good, with a high patient satisfaction level. One case with swelling was obtained good results after a subsequent defatting procedure. The sensation of flaps partially recovered six months later.Conclusions:Thinned DIEP flaps provided sufficient tissue volumes for repairing large defects of the scrotal, which provided reliable blood flow and strong anti-infection capacity. The flap tissues could protect the scrotal contents. These advantages improved the patients’ satisfaction postoperatively. The thinned DIEP flap is a feasible choice to repair large defects of the scrotum.
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