Ⅱb型游离股前外侧嵌合皮瓣修复复杂创面的临床疗效观察OA

Objective To evaluate the clinical efficacy of the Zunyi type Ⅱ b free anterolateral thigh chimeric flap in repairing complex wounds.Methods A retrospective cohort study was conducted,including 22 patients with complex wounds admitted between June 2021 and June 2024.All patients underwent repair and reconstruction using the Zunyi type Ⅱb free anterolateral thigh chimeric flap.The flap was designed based on a single vascular pedicle with multiple perforator branches in a lobulated pattern and was customized according to the shape and number of wounds.The chimeric flap could combine skin with one or more tissue types,including fascia lata,muscle,and sensory nerve.The primary outcome measures included flap survival rate,complication rate,donor site morbidity,and long-term functional outcomes.Results Among the 22 patients,7 underwent repair with flap+fascia lata,8 with flap+muscle,and 7 with flap+sensory nerve.The overall flap survival rate was high.Only one patient developed vascular crisis on the night after surgery,and the flap survived after emergency exploration,resulting in an actual survival rate of 100%(22/22).No donor site complications occurred in any patient.During a follow-up period of 6 to 24 months(median 11.5 months),no adverse events such as ulcer recurrence,wound infection,or lobulated flap necrosis were observed.All patients achieved satisfactory outcomes in wound repair and functional reconstruction.Conclusion The Zunyi type Ⅱ b free anterolateral thigh chimeric flap provides a reliable and flexible surgical option for complex wound repair.By integrating multiple tissue types into a single vascular pedicle and enabling lobulated design to simultaneously cover multiple or irregular wounds,this technique achieves effective tissue coverage,functional reconstruction,and long-term durability.These findings support the further clinical application of the Zunyi classification in repair and reconstruction strategies for complex wounds.