关键词: 软组织缺损, 皮瓣成活率, 感觉功能, 手足功能, 端侧吻合

Abstract: Objective To investigate the application effect of the anterolateral thigh perforator flap (ALTPF) with end-to-side anastomosis of non-primary source vessels in repairing soft tissue defects in the hands and feet.Methods Ninety-six patients with soft tissue defects in the hands and feet of the Third People's Hospital of Xinjiang Uygur Autonomous Region from March 2021 to June 2023 were randomly divided into two groups using a random number table method,with 48 cases in each group.The control group was treated with a conventional subcutaneous artery perforator flap,while the observation group was treated with an end-to-side anastomosis of non-primary source vessels using an ALTF.The repair indicators of tissue defects,the recovery of sensory function,the recovery of hand and foot function,and the incidence of complications were compared between the two groups at 1 month and 3 months after surgery.Results The wound healing time in the observation group and the control group was (19.35±3.89) days and (23.72±4.76) days,respectively,with a statistically significant difference (P<0.05).There was no significant difference in the preparation time,survival rate,and stage I healing rate of the two groups of skin flaps (P>0.05).At 1 month and 3 months after surgery,the proportions of patients with pain sensation in the observation group and control group were 70.83% and 50.00%,respectively,and 100.00% and 79.17%,respectively.The proportions of patients with cold and hot sensation were 66.67% and 45.83%,respectively,and 97.92% and 72.92%,respectively.The distance of two-point discrimination was (30.69±6.10) mm and (34.40±7.36) mm,respectively,and (15.23±3.72) mm and (22.36±5.28) mm,respectively,with a statistically significant difference (P<0.05).There was no significant difference in the excellent and good rate of hand and foot function between the two groups 3 months after surgery (P>0.05).The incidence of complications in the observation group was 4.17%,which was lower than that in the control group (22.91%),and the difference was statistically significant (P<0.05).Conclusion ALTPF repair of soft tissue defects in the hands and feet with end-to-side anastomosis of non-primary source vessels can improve wound healing rates,improve sensory function,and reduce the incidence of complications.

Key words: soft tissue defect, survival rate of skin flap, sensory function, hand and foot function, end-to-side anastomosis