[Application of free-style perforator flap for soft tissue defect of knee].

To investigate the effectiveness of free-style perforator flap in repairing the soft tissue defect of knee.Between December 2011 and October 2017, 13 patients with the soft tissue defects of knees were repaired with the free-style perforator flaps. There were 9 males and 4 females, with an average age of 40 years (range, 14-65 years). The injuries were caused by traffic accident in 7 cases, crushing in 4 cases, and falling from height in 2 cases. The soft tissue defects in 9 cases formed after 2 weeks-2 months (mean, 1 month) of lower extremity fractures fixation. The other 4 cases were urgently admitted to the hospital after injury, and the time from injury to admission was 0.5-18.0 hours (mean, 8 hours). The size of soft tissue defect ranged from 3 cm×2 cm to 12 cm×8 cm after debridement. Nine propeller flaps, 6 rotating flaps, and 2 V-Y advanced flaps were used; and 9 cases were repaired by single flap and 4 cases were repaired by combined flaps. The size of flap ranged from 7.5 cm×2.5 cm to 20.0 cm×6.0 cm. The donor sites were sutured directly.The flaps survived smoothly and incisions healed by first intention in 12 cases. The congestion occurred in 1 case, which obtained delayed healing after symptomatic treatment. All incisions at donor sites healed by first intention. All patients were followed up 3-24 months with an average of 6 months. The shape and motions of knee were satisfactory.The free-style perforator flap can maximize the utilization of the donor area around the knee wound, with reliable blood supply, small trauma, and easy operation. It is an ideal flap for the soft tissue defect of knee.总结自由式穿支皮瓣修复膝部软组织缺损的疗效。.2011 年 12 月—2017 年 10 月，采用自由式穿支皮瓣修复 13 例膝部软组织缺损。男 9 例，女 4 例；年龄 14～65 岁，平均 40 岁。致伤原因：交通事故伤 7 例，碾压伤 4 例，高处坠落伤 2 例。9 例伤后行下肢骨折固定治疗 2 周～2 个月后形成膝部软组织缺损，平均 1 个月；4 例为急诊入院，受伤至入院时间为 0.5～18.0 h，平均 8 h。清创后皮肤软组织缺损范围为 3 cm×2 cm～12 cm×8 cm。术中设计螺旋桨皮瓣 9 个、旋转皮瓣 6 个、V-Y 推进皮瓣 2 个，其中单个皮瓣修复 9 例、组合皮瓣修复 4 例。皮瓣切取范围为 7.5 cm ×2.5 cm～20.0 cm×6.0 cm。供区均直接拉拢缝合。.术后 12 例皮瓣均顺利成活，创面 Ⅰ 期愈合；1 例发生皮瓣淤血，对症处理后延迟愈合。供区切口均 Ⅰ 期愈合。患者均获随访，随访时间 3～24 个月，平均 6 个月。膝部外形及屈伸功能均满意。.自由式穿支皮瓣可以最大程度利用膝部创面周围供区，血供可靠、创伤小、操作简便，是修复膝部软组织缺损的理想皮瓣。.