Repair of limb wounds with free profunda artery perforator flap in posteromedial femoral region

目的: 探讨应用股后内侧区游离股深动脉穿支皮瓣（profunda artery perforator flap，PAPF）修复外伤性肢体皮肤缺损的疗效。. Methods: Between March 2015 and April 2017, 11 cases of traumatic limb skin defect with deep tissue exposure were treated with free PAPF in posteromedial femoral region. There were 7 males and 4 females, with an average age of 39 years (range, 26-54 years). There were 4 cases of upper limb skin defect and 7 cases of lower limb skin defect. The causes of injury included 6 cases of traffic accident injury, 3 cases of machine crush injury, and 2 cases of crush injury. The size of wounds ranged from 11 cm×7 cm to 18 cm×11 cm. The time from post-traumatic admission to flap repair were 4-9 days (mean, 7.3 days). The size of free PAPF ranged from 15 cm×9 cm to 22 cm×13 cm. The donor site of 8 cases were closed directly; 3 cases could not be closed directly, and skin grafting was used to cover the wound. 结果: 术中皮瓣切取时间为 40～90 min，平均 47 min。术后所有皮瓣及植皮区均顺利成活，创面Ⅰ期愈合。11 例患者均获随访，随访时间 6～19 个月，平均 12 个月。皮瓣质地柔软，颜色与伤肢周围皮肤相似，无明显色素沉着及毛发生成。其中 3 例患者进行了二期皮瓣修薄。末次随访时所有患者伤肢功能恢复良好。皮瓣供区可见纵形瘢痕，位置隐蔽；所有患者随访过程中均未诉皮瓣供区瘢痕影响性生活。. Conclusion: Free PAPF can achieve satisfactory results in repairing skin defects of extremities. The flaps have the advantages including constant perforator branches, simple operation, and concealed donor site.