CAJ | 학술논문

目的探讨小儿背阔肌皮瓣游离移植修复下肢严重损伤的可行性及远期疗效.方法 1999年7月-2004年6月,对9例6～13岁儿童下肢严重损伤,涉及小腿及足踝部大面积软组织缺损,伴复杂的开放性骨折与裸露的关节脱位、肌腱神经血管损伤,均采用背阔肌皮瓣游离移植修复,皮瓣面积最大30 cm×12 cm,最小10 cm×5 cm.结果 9例皮瓣全部成活,成功率100%;随访4～9年,移植皮瓣血运正常,外形及功能良好,皮瓣供区功能无明显影响.结论背阔肌皮瓣解剖位置恒定,部位隐蔽,血运丰富,切取面积大,抗感染能力强,对供区影响小,在显微外科技术娴熟的条件下,是修复小儿下肢严重损伤的理想方法.
목적 탐토소인배활기피판유리이식수복하지엄중손상적가행성급원기료효.방법 1999년7월-2004년6월,대9례6～13세인동하지엄중손상,섭급소퇴급족과부대면적연조직결손,반복잡적개방성골절여라로적관절탈위、기건신경혈관손상,균채용배활기피판유리이식수복,피판면적최대30 cm×12 cm,최소10 cm×5 cm.결과 9례피판전부성활,성공솔100%;수방4～9년,이식피판혈운정상,외형급공능량호,피판공구공능무명현영향.결론 배활기피판해부위치항정,부위은폐,혈운봉부,절취면적대,항감염능력강,대공구영향소,재현미외과기술한숙적조건하,시수복소인하지엄중손상적이상방법.
Objective To discuss the feasibility and long-term effect of free latissimus dorsi muscle flap in repair of severe lower extremity injury in children. Methods From July 1999 to June 2004, nine child patients (at age of 6-13 years) with severe lower extremity injury involving soft tissue defects a-round the calf and the foot associated with complex open fractures, bare dislocation, and injury of the nerve, tendon and artery were repaired with free latissimus donsi flap, with flap area ranging from 30 cm ×12 cm to 10 cm × 5 cm. Results All the latissimus dorsi flaps survived, with success rate of 100%. A follow-up for 4-9 years showed that the flap had sound shape and function and normal blood supply, without significant influence on donor area. Conclusion Latissimus dorsi flap has advantages of constant anatomical site, abundant blood supply, massive area, strong anti-infection ability and less in-fluence on donor area and hence is an ideal method for repairing severe lower extremity injury in children.