游离背阔肌肌(皮)瓣联合植皮修复四肢大面积软组织缺损创面15例OA

Objective:To investigate the clinical efficacy of free latissimus dorsi muscle(skin)flaps combined with skin grafting for the repair of extensive soft tissue defects in the extremities.Methods:A retrospective study was conducted,en-rolling 15 patients who underwent latissimus dorsi muscle(skin)flap reconstruction for extensive soft tissue defects of the extremities between October 2021 and June 2025.Patient-including gender,age,cause of injury,defect size,concomi-tant tendon and nerve injuries,flap harvest site,and follow-up outcomes-were recorded.Functional outcomes were as-sessed using the AOFAS ankle and foot score for 12 patients with lower limb soft tissue defects and the DASH score for 3 patients with upper limb soft tissue defects,supplemented by joint range of motion measurements for descriptive evalua-tion.Thick-punch skin grafts were harvested from the lateral thigh and applied using a 1∶3 mesh-pattern technique.During follow-up lasting 6-18 months,the POSAS with the SBSES score was used to assess scarring in the limbs,and the VSS score was used to evaluate the appearance of the grafted are-as.Results:In 14 of the 15 patients,both the muscle flaps and skin grafts survived completely,and wound healing was sat-isfactory.In one patient,necrosis developed at the distal end of the muscle flap;after debridement of the superficial necrotic tissue and subsequent skin grafting,the patient recovered.The postoperative AOFAS score for the 12 lower limb patients was(78.50±7.44)points,indicating a generally good lev-el of functional recovery;the 3 lower-limb patients had a postoperative DASH score of(28.00±3.00)points,a median POSAS score of 16 points(range:13.5-17.0),a median SBSES score of 3 points(range:3-4),and a median VSS score of 3 points(range:3-4),indicating that the overall scar condition was acceptable.Conclusion:The latissimus dorsi muscle is the largest muscle in the human body.Compared to other flaps,it features a longer vascular pedicle and larger vessel diameters,with well-defined blood supply,consistent anatomical structure,appropriate arterial and venous diameters,and abundant anastomotic options.These characteristics make it highly suitable for the repair of large-area soft tissue defects in the extremities,thereby helping patients improve limb function.