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目的:探讨游离双股前外侧超长穿支皮瓣串并联修复四肢大面积创面的临床效果。方法:2017年1月—2019年7月，苏州大学附属瑞华医院手外科与足踝外科收治9例四肢大面积皮肤软组织缺损患者，其中男8例、女1例，年龄36~63岁，行回顾性队列研究。本组患者清创/扩创后创面面积为20 cm×15 cm~30 cm×25 cm，采用双侧股前外侧超长穿支皮瓣修复。4例患者受区1条主干动脉缺损，行双侧皮瓣串联修复；5例患者受区2条主干动脉缺损，行双侧皮瓣并联修复。共切取18个皮瓣，单个皮瓣切取面积为20 cm×8 cm~46 cm×9 cm。17个皮瓣供区直接缝合，1个皮瓣供区游离移植下腹部全厚皮片覆盖。记录皮瓣切取时间、术后皮瓣成活情况、创面愈合时间，随访时皮瓣情况、皮瓣两点辨别觉距离、受区关节功能恢复情况及外形、供区恢复情况。结果:本组患者皮瓣切取时间为1.0~4.5 h，18个皮瓣均成活，皮瓣修复后至受区创面愈合时间为18~72 d，供区均愈合。随访6~34个月，患者受区外形较佳，无骨髓炎等深部组织感染。2例患者4个皮瓣臃肿，术后6个月行皮瓣修整；2例患者4个皮瓣边缘出现色素沉着；1例患者皮瓣被烫伤，经换药后愈合，随访遗留斑片状瘢痕；其余皮瓣质地柔软，弹性好，无疼痛，血运良好；所有皮瓣均恢复保护性感觉，两点辨别觉均仅有1个点。17个皮瓣供区只遗留线性瘢痕。所有供区远端肢体血运正常，膝关节活动度及股四头肌肌力均无受限。结论:采用串并联形式的双侧股前外侧超长穿支皮瓣能，皮瓣解剖恒定、血供可靠、组合方式灵活，是一次修复肢体巨大面积的皮肤软组织缺损的较理想的手术方法。“,”Objective:To explore the clinical effects of free bilateral overlength anterolateral femoral perforator flaps in repairing large area soft tissue defects of limbs by series or parallel connection of blood vessels.Methods:Form January 2017 to July 2019, 9 patients with large area soft tissue defects of limbs were admitted to the Departments of Hand Surgery and Foot and Ankle Surgery of Ruihua Affiliated Hospital of Soochow University, including 8 males and 1 female, aged 36 to 63 years. The historical cohort study was conducted. The areas of wounds of patients after debridement were 20 cm×15 cm to 30 cm×25 cm, and were repaired with bilateral anterolateral femoral perforator flap whose blood vessel was connected in series or parallel. One main artery of 4 patients were injured, then the wounds were repaired with bilateral flap whose blood vessel was connected in series; Two main arteries of 4 patients were injured, then the wounds were repaired with bilateral flap whose blood vessel was connected in parallel. Eighteen flaps were excised and the area of single flaps ranged from 20 cm×8 cm to 46 cm×9 cm. Seventeen donor sites were sutured directly, and one donor site was repaired with free full-thickness skin graft from hypogastrium. Harvesting time and survival condition of flaps, wound healing time, flap observation at follow-up, two-point discrimination distance of flaps, functional recovery and appearance of recipient site, function of donor site were recorded.Results:In this group of 9 patients, the flap harvesting time was 1.0 to 4.5 hours, and all the 18 flaps survived. The wound healing time was 18 to 72 days after flap transplantation, the donor sites were all healed. They were followed up for 6 to 34 months. The shape of the recipient site was satisfactory, with no deep tissue infection such as osteomyelitis. The appearance of 4 flaps were slightly bloated in 2 cases which were thinned in 6 months after operation; 4 flaps of 2 cases had skin pigmentation on the edge of the flap; one case was scalded on the medial skin flap with patchy scars remained after healing. All the flaps of other cases were soft, elastic, good in blood supply with no pain. All the flaps were with protective feeling recovery, with only one point in two-point discrimination. Only linear scars remained in the 17 flap donor sites. All the limbs in distal end of donor sites had good blood supply, no restriction occurred in range of knee motion or quadriceps strength.Conclusions:The bilateral anterolateral femoral perforator flap whose blood vessel was connected in series or parallel has constant anatomy, reliable blood supply, and flexible combination, may be an ideal surgical method to repair large area soft tissue defects of limbs in one stage.