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目的：探讨应用胫前动脉逆行供血的背阔肌肌皮瓣游离移植修复小腿中上段大面积皮肤软组织缺损的方法及疗效。方法2011年1月至2015年1月，使用胫前动脉逆行供血的背阔肌肌皮瓣游离移植修复小腿中上段严重复合性损伤的大面积皮肤软组织缺损共6例，肌皮瓣的胸背动脉及胸背静脉分别与胫前动脉远断端及大隐静脉或小隐静脉近断端行端端吻合，肌皮瓣肌肉裸露部分表面予对侧大腿中厚皮片移植覆盖。结果术后肌皮瓣血运良好，皮瓣及植皮均完全成活，随访6～12个月，皮瓣及植皮外形良好，质地柔软。结论对于小腿中上段大面积皮肤软组织缺损伴有胫前血管破坏及小腿软组织严重受损的复杂病例，应用胫前动脉逆行供血的背阔肌肌皮瓣游离移植进行修复，是一种安全、有效、值得推荐的手术方法。“,”Objective To investigate the validity and efficacy of the free Latissimus Dorsi ( LD ) flap supplied by reverse anterior tibial artery for massive wound closure in the middle to proximal leg. Methods From January 2011 to January 2015, 6 cases of massive compound trauma in the middle to proximal leg were treated by free LD flap. The thoracodorsal artery and its accompany vein were anastomosed to the distal end of the anterior tibial artery and the proximal end of great saphenous vein or small saphenous vein respectively. Skin grafting from leg offside was applied to the uncovered areas of the flap. Results All flaps presented good blood supply and survived without complications. At 6 to 12 months’ follow-up, flaps were soft and aesthetically acceptable. Conclusions For compound trauma in the middle to proximal leg that involves anterior tibial vessel defect, LD flap application supplied by the reverse anterior tibial artery is a safe and effective approach with good outcomes.