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目的 探讨制备游离带感觉超薄股前外侧穿支皮瓣修复(足母)甲瓣供区的可行性及临床疗效.方法 2011年5月-2013年12月,以游离带感觉超薄股前外侧穿支皮瓣修复9例拇指缺损患者的(足母)甲瓣供区.男8例,女1例;年龄19 ～ 42岁,平均31.2岁.伤后至入院时间为3～12h,平均6.5h.致伤原因:机器碾压伤4例,交通事故伤3例,绞伤2例.采用(足母)甲瓣游离移植重建拇指后,遗留供区软组织缺损范围为3 cm×2 cm～8 cm×5 cm.携带股外侧皮神经分支制备带感觉股前外侧穿支皮瓣,游离移植修复供区创面;皮瓣切取范围为3.0 crm×2.0 cm ～ 8.5 crm×5.0 cm.皮瓣修薄前厚度为2,0～ 4,5 cm,平均3.2 cm;皮瓣修薄后厚度为0.4～0.6 cm,平均0.5 cm.所有股前外侧皮瓣供区直接闭合.结果 术后所有再造拇指和皮瓣均成活.随访时间6～30个月,平均15.8个月.皮瓣质地和色泽与周围皮肤接近,外形不臃肿,两点辨别觉为8～ 15mm,平均10.5 mm.患者大腿功能未见明显影响.结论 游离带感觉超薄股前外侧穿支皮瓣质地薄且易塑形,适用于修复(足母)甲瓣供区缺损.“,”Objective To explore the feasibility of harvesting free thinned innervated anterolateral thigh (ALT)perforator flap for repairing the donor defect after wrap-around flap transfer.Methods Between May 2011 and December 2013,free thinned innervated ALT perforator flap was used to repair the donor defects after wrap-around flap transfer in 9 patients.There were 8 males and 1 female,with a mean age of 31.2 years (range,19-42 years).The interval time between injury and admission was 3-12 hours (mean,6.5 hours).Injury causes included machine crush injury (4 cases),traffic accident injury (3 cases),and twisting injury (2 cases).The wrap-around flaps were transferred to reconstruct thumb defects.And the size of donor site defect ranged from 3 cm×2 cm to 8 cm×5 cm.A branch of the lateral femoral cutaneous nerve was carried to make innervated ALT perforator flap for donor site repair.The size of innervated ALT perforator flap ranged from 3.0 cm×2.0 cm to 8.5 cm×S.0 cm.The thickness of innervated ALT perforator flap before defatting ranged from 2.0 to 4.5 cm (mean,3.2 cm);the thickness after defatting ranged from 0.4 to 0.6 cm (mean,0.5 cm).The defect at the anterolateral thigh was primarily closed in all cases.Results All reconstructed thumbs and ALT perforator flaps survived.All patients were followed up 6-30 months (mean,15.8 months).The ALT perforator flaps had good appearance and color,with no further flap revision or defatting procedures.The static two-point discrimination was 8-15 mm (mean,10.5 mm).All patients could walk and run normally without postoperative skin erosions or ulcerations.Conclusion The free thinned innervated ALT perforator flap is pliable and thin.It is suitable for repairing the donor site defects after wrap-around flap transfer for thumb reconstruction.