双侧预扩张肩胛皮瓣游离移植修复下肢大面积皮肤软组织缺损OA

Objective To investigate the clinical effects of free transplantation of bilateral pre-expanded scapular in reconstruction of extensive soft tissue defects of the lower extremity.Methods A total of 10 patients with large-area soft tissue defects of the lower extremity,who were admitted to the Department of Plastic Surgery,Beijing Luhe Hospital Affiliated to Capital Medical University between July 2023 and July 2025,were selected as the research subjects,and all of them were treated with free transplantation of bilateral pre-expanded scapular flaps for repair.In the first stage,two expanders were implanted in the bilateral scapular regions and gradually inflated postoperatively.In the second stage,a portable Doppler ultrasound device was used to detect the bilateral circumflex scapular arteries pre-operatively.A scapular flap was designed based on the bilateral circumflex scapular vessels according to the shape and size of the defect.The vascular pedicles were carefully dissected intraoperatively and the flap was harvested and free transferred to the resulting defect following the removal of the lesion in the lower extremity.The donor site was closed primarily.Postoperative complications were recorded and analyzed.Results A total of 10 flaps were transferred and 8 flaps survived completely.One flap experienced complete necrosis and was managed with debridement followed by skin grafting.The remaining one flap developed distal necrosis and healed with conservative management.During the follow-up period of 1-24 months,none of the patients developed contour deformities or functional impairments.All patients were satisfied with both functional and aesthetic outcomes.Conclusion Fee transplantation of bilateral pre-expanded scapular flap provides reliable and effective reconstruction for extensive soft tissue defects of the lower extremity,demonstrating high feasibility and offering a novel option for large-sized lower limb defect repair.