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目的:探讨股前外侧穿支皮瓣组合移植修复上肢巨大面积皮肤软组织缺损的可行性，及临床应用的初步效果。方法:自2011年1月至2017年10月收治上肢巨大面积皮肤软组织缺损患者15例。术前Doppler探测确认并标记股前外侧穿支。根据创面形状及大小设计布样，根据“提捏实验”判断供区所能切取的皮瓣宽度，裁剪布样，以供区能直接闭合为原则，选择合适的穿支设计皮瓣，皮瓣切取面积最小15 cm×7 cm～8 cm×7 cm，最大33 cm×10 cm～32 cm×10 cm。携带“T”形血管蒂，组合移植修复上肢创面，吻合供区与受区血管，重建皮瓣血运。供区均直接闭合。结果:术后14例患者皮瓣均顺利存活。1例患者一侧股前外侧分叶穿支皮瓣其中一叶于术后第二天出现静脉危象，及时探查，重新吻合皮下静脉，实施内减压术，术后皮瓣完全存活。所有皮瓣受区均Ⅰ期愈合。全部病例随访3～36个月，平均12个月，受区外观、功能恢复满意，供区仅残留线性瘢痕。结论:股前外侧穿支皮瓣组合移植是修复上肢巨大面积皮肤软组织缺损较为理想的方法，值得临床推广应用。“,”Objective:To investigate the feasibility and clinical application of anterolateral thigh perforator flap in repairing large area skin and soft tissue defects of upper limbs.Methods:From January 2011 to October 2017, 15 patients with large area skin and soft tissue defects of upper limbs were treated. The anterolateral femoral perforator was identified and marked by Doppler detection. According to the shape and size of the wound, the cloth sample was designed. According to the “lifting and kneading test” , the width of the flap that could be cut from the donor site was determined. The appropriate perforator was selected to design flap based on the principle that the donor site could be closed directly. The minimum cutting area of the flap was 15 cm×7 cm to 8 cm×7 cm, and the maximum area was 33 cm×10 cm to 32 cm×10 cm. The “T” shaped vascular pedicle was used to repair the upper limb wound, and the blood supply of the flap was reconstructed by anastomosing the blood vessels of the donor site and the recipient area. All the donor sites were closed directly.Results:After operation 14 flaps survived successfully. One patient had venous crisis of one lobule of the anterolateral thigh lobulated perforator flaps on the second day after operation. The flap survived completely after timely exploration, reanastomosis of subcutaneous vein and internal decompression. All the recipient area of flaps achieved primary healing. All the patients were follow-up for 3 to 36 months with an average of 12 months. The appearance and function of recipient area recovered satisfactorily. Only linear scar remained in donor site.Conclusion:The combined anterolateral thigh perforator flap transplantation is an ideal method to repair large area skin and soft tissue defects of upper limbs, which is worthy of clinical application.