摘要
目的探讨从创伤性离断肢体切取游离皮瓣修复小腿残端软组织缺损的临床疗效。方法2001年5月-2005年6月，应用从创伤性离断肢体切取游离皮瓣的方法修复6例小腿截肢残端软组织缺损创面，其中男5例，女1例，年龄25～42岁，平均31岁。右侧4例，左侧2例。均行急诊手术，应用吻合胫后血管与神经的游离足底皮瓣5例，吻合胫前血管与腓浅神经的游离足背皮瓣1例。皮瓣面积为8cm×10cm～9cm×12cm。结果1例术后发生表浅感染，经更换敷料逐渐愈合，皮瓣全部成活。所有患者随访1．8—3．5年，平均2．7年。受区外形和膝关节功能恢复良好。结论切取创伤性离断肢体游离皮瓣，具有血管解剖恒定、血管蒂长和切取容易等优点，修复后的肢体残端愈合好、局部无疼痛、耐磨，避免了从其它部位切取皮瓣而导致的并发症，可保留创伤性截肢残端有功能的长度和膝关节功能。
Objective To report the clinical results of repair of soft-tissue defects at the leg amputation stump with a free flap from the traumatic amputated part. Methods Six cases （5 men, 1 women） of soft-tissue defects at the leg amputation stump were repaired by the technique mentioned above to achieve primary stump closure and to preserve the leg length. Their ages ranged from 25 to 42 years old （mean 31y）. Four right legs and 2 left ones were involved. The sizes of flaps used ranged from 8 cm × 10 cm to 9 cm × 12 cm. Free plantar flaps pedicled with posterior tibial vessels and nerves were applied in 5 cases and free dorsal flap pedicled with anterior tibial vessels and superficial peroneal nerve in 1 case. Results One case suffered from postoperative superficial infection which healed by daily wound dressing. All the flaps survived completely with satisfactory clinical results. All the patients were followed up from 1.8 to 3.5 years （mean, 2.7y）. The cosmetic appearance on the recipient area and function of the knee was good. Conclusions The flaps from the traumatic amputated part have a constant vascular structure and a long vascular pedicle so that dis- section of the flaps could be accomplished easily. The surgery can preserve the maximal functional length or the knee function of the remaining stump after traumatic amputation, and ensure primary pain-free healing of a durable cylindrical stump without donor-site morbidity.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第3期210-213,共4页
Chinese Journal of Orthopaedic Trauma
关键词
外科皮瓣
软组织损伤
创伤
离断肢体
显微外科
Surgical flaps
Soft-tissue defect
Trauma
Amputated limb
Microsurgery
