中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2010年
4期
256-259
,共4页
朱雄翔%郑朝%胡大海%徐明达%韩军涛%董茂龙%王洪涛%陶克%谢松涛%计鹏%王耀军
硃雄翔%鄭朝%鬍大海%徐明達%韓軍濤%董茂龍%王洪濤%陶剋%謝鬆濤%計鵬%王耀軍
주웅상%정조%호대해%서명체%한군도%동무룡%왕홍도%도극%사송도%계붕%왕요군
烧伤创面%组织瓣%游离移植
燒傷創麵%組織瓣%遊離移植
소상창면%조직판%유리이식
Burn wounds%Tissue flaps%Free transplantation
目的 了解早期应用游离复合组织瓣修复毁损性创面的安全性与效果. 方法 2005-2009年,笔者单位采用游离皮瓣或复合组织瓣修复123例患者128处毁损性创面.所采用的复合组织瓣类型:背阔肌肌皮瓣58例、股前外侧皮瓣32例、旋肩胛皮瓣21例、足背复合组织瓣6例、拇甲瓣3例、前臂皮瓣3例、侧胸皮瓣1例.另行游离背阔肌肌瓣移植+植皮3例、带腓骨小腿外侧皮瓣移植1例. 结果 10例患者术后1～5 d发生血管危象,经紧急手术后修复6例.皮瓣或复合组织瓣移植成活率为95.3%(122/128).随访3个月～4年,皮瓣外形良好,部分功能得以重建.结论 游离复合组织瓣移植降低了截肢率,能Ⅰ期重建功能、更好地恢复外形、减少手术次数、降低并发症发生率、缩短住院时间、减少治疗费用,是修复较大毁损性软组织损伤的较佳方法 .
目的 瞭解早期應用遊離複閤組織瓣脩複燬損性創麵的安全性與效果. 方法 2005-2009年,筆者單位採用遊離皮瓣或複閤組織瓣脩複123例患者128處燬損性創麵.所採用的複閤組織瓣類型:揹闊肌肌皮瓣58例、股前外側皮瓣32例、鏇肩胛皮瓣21例、足揹複閤組織瓣6例、拇甲瓣3例、前臂皮瓣3例、側胸皮瓣1例.另行遊離揹闊肌肌瓣移植+植皮3例、帶腓骨小腿外側皮瓣移植1例. 結果 10例患者術後1～5 d髮生血管危象,經緊急手術後脩複6例.皮瓣或複閤組織瓣移植成活率為95.3%(122/128).隨訪3箇月～4年,皮瓣外形良好,部分功能得以重建.結論 遊離複閤組織瓣移植降低瞭截肢率,能Ⅰ期重建功能、更好地恢複外形、減少手術次數、降低併髮癥髮生率、縮短住院時間、減少治療費用,是脩複較大燬損性軟組織損傷的較佳方法 .
목적 료해조기응용유리복합조직판수복훼손성창면적안전성여효과. 방법 2005-2009년,필자단위채용유리피판혹복합조직판수복123례환자128처훼손성창면.소채용적복합조직판류형:배활기기피판58례、고전외측피판32례、선견갑피판21례、족배복합조직판6례、무갑판3례、전비피판3례、측흉피판1례.령행유리배활기기판이식+식피3례、대비골소퇴외측피판이식1례. 결과 10례환자술후1～5 d발생혈관위상,경긴급수술후수복6례.피판혹복합조직판이식성활솔위95.3%(122/128).수방3개월～4년,피판외형량호,부분공능득이중건.결론 유리복합조직판이식강저료절지솔,능Ⅰ기중건공능、경호지회복외형、감소수술차수、강저병발증발생솔、축단주원시간、감소치료비용,시수복교대훼손성연조직손상적교가방법 .
Objective To study the safety and effects of free composite tissue flaps in repairing devastating wounds in early stage. Methods One hundred and twenty-three patients with 128 devastating wounds hospitalized in our burns center from 2005 to 2009 were repaired with free flaps or composite tissue flaps. Flap types used included 58 latissimus dorsi muscular flaps, 32 anterolateral thigh flaps, 21 circumflex scapular flaps, 6 dorsalis pedis composite flaps, 3 big toe nail skin flaps, 3 forearm flaps, and 1 lateral thoracic flap. One wound was repaired with lateral lower leg flap with fibula, and 3 wounds with free latissimus dorsi muscular flap plus skin graft. Results Vascular crisis was observed in 10 transplanted flaps 1 to 5 days after operation; 6 flaps with this complication were saved after emergency surgical exploration. Total survival rate of transplanted flaps and composite tissue flaps was 95.3% (122/128). All patients were followed up for 3 months to 4 years; satisfactory appearance and restoration of partial function were found in all of them. Conclusions Free composite tissue transplantation reduces amputation rate, achieves primary reconstruction of function with good appearance, shortens length of hospital stay, and reduces surgical operation time, complications, and treatment cost. It is a good approach in the repair of massive devastating soft tissue injury.
