中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2009年
2期
116-118,插4
,共4页
滕云升%刘重%智丰%刘少军%郭永明%张朝%赵玲珑%吴勐%梁高锋%李涛%石宇
滕雲升%劉重%智豐%劉少軍%郭永明%張朝%趙玲瓏%吳勐%樑高鋒%李濤%石宇
등운승%류중%지봉%류소군%곽영명%장조%조령롱%오맹%량고봉%리도%석우
腓骨皮瓣%股前外侧皮瓣%移植%显微外科
腓骨皮瓣%股前外側皮瓣%移植%顯微外科
비골피판%고전외측피판%이식%현미외과
The cutaneous fibular flap%Anterolateral thigh flap%Transplantation%Microsurgery
目的 探讨腓骨骨皮瓣与股前外侧皮瓣组合移植修复严重小腿软组织缺损并骨缺损的临床效果.方法 应用腓骨骨皮瓣与股前外侧皮瓣串联或并联组合移植,修复严重小腿软组织缺损并骨缺损36例.新鲜无菌创面10例,晚期感染创面26例.创面面积25 cm×18 cm～45 cm×13 cm,平均36 cm×16 cm,股前外侧皮瓣切取范围12 cm×13 cm～32 cm×18 cm,腓骨骨皮瓣切取范围2.0 cm×1.5 cm～18.0 cm×16.0 cm,腓骨切取长度10～24 cm.并联移植30例,串联移植6例,急诊手术5例,亚急诊手术5例,择期手术26例.结果 36例全部成功,35例获得随访,随访时间1～3年.术后发生动脉危象1例,静脉危象2例.移植组织全部成活34例,2例并联腓骨皮瓣部分坏死,行皮片移植后愈合.修复创面一期愈合32例,二期愈合4例,愈合时间12～28d,腓骨移植骨愈合时间3～6个月.应用Enneking评分23～28分,平均26分,供区无功能障碍.结论 腓骨骨皮瓣与股前外侧皮瓣组合移植修复小腿软组织缺损并骨缺损可使复杂创面修复一期完成,虽难度大风险高,但仍是一种理想的治疗方法.
目的 探討腓骨骨皮瓣與股前外側皮瓣組閤移植脩複嚴重小腿軟組織缺損併骨缺損的臨床效果.方法 應用腓骨骨皮瓣與股前外側皮瓣串聯或併聯組閤移植,脩複嚴重小腿軟組織缺損併骨缺損36例.新鮮無菌創麵10例,晚期感染創麵26例.創麵麵積25 cm×18 cm～45 cm×13 cm,平均36 cm×16 cm,股前外側皮瓣切取範圍12 cm×13 cm～32 cm×18 cm,腓骨骨皮瓣切取範圍2.0 cm×1.5 cm～18.0 cm×16.0 cm,腓骨切取長度10～24 cm.併聯移植30例,串聯移植6例,急診手術5例,亞急診手術5例,擇期手術26例.結果 36例全部成功,35例穫得隨訪,隨訪時間1～3年.術後髮生動脈危象1例,靜脈危象2例.移植組織全部成活34例,2例併聯腓骨皮瓣部分壞死,行皮片移植後愈閤.脩複創麵一期愈閤32例,二期愈閤4例,愈閤時間12～28d,腓骨移植骨愈閤時間3～6箇月.應用Enneking評分23～28分,平均26分,供區無功能障礙.結論 腓骨骨皮瓣與股前外側皮瓣組閤移植脩複小腿軟組織缺損併骨缺損可使複雜創麵脩複一期完成,雖難度大風險高,但仍是一種理想的治療方法.
목적 탐토비골골피판여고전외측피판조합이식수복엄중소퇴연조직결손병골결손적림상효과.방법 응용비골골피판여고전외측피판천련혹병련조합이식,수복엄중소퇴연조직결손병골결손36례.신선무균창면10례,만기감염창면26례.창면면적25 cm×18 cm～45 cm×13 cm,평균36 cm×16 cm,고전외측피판절취범위12 cm×13 cm～32 cm×18 cm,비골골피판절취범위2.0 cm×1.5 cm～18.0 cm×16.0 cm,비골절취장도10～24 cm.병련이식30례,천련이식6례,급진수술5례,아급진수술5례,택기수술26례.결과 36례전부성공,35례획득수방,수방시간1～3년.술후발생동맥위상1례,정맥위상2례.이식조직전부성활34례,2례병련비골피판부분배사,행피편이식후유합.수복창면일기유합32례,이기유합4례,유합시간12～28d,비골이식골유합시간3～6개월.응용Enneking평분23～28분,평균26분,공구무공능장애.결론 비골골피판여고전외측피판조합이식수복소퇴연조직결손병골결손가사복잡창면수복일기완성,수난도대풍험고,단잉시일충이상적치료방법.
Objective To explore the clinical application and effect of the transplantation of the cutaneous fibular flap combined with anterolateral thigh flap for the repair of complex tissue defect of the leg. Methods The cutaneous fibular flap combined with anterolateral thigh flap in series connection or parallel connection transfer were applied to repair complex tissue defect of the leg in 36 cases. 10 cases were fresh non-infectious wound 26 cases were delayed infectious wound. The area of wound ranged from 25 cm × 18 cm to 45 cm × 13 cm (36 cm × 16 cm on average). The area of anterolateral thigh flap ranged from 12 cm × 13 cm to 32 cm × 18 cm. The area of the cutaneous fibular flap ranged from 2.0 cm × 1.5 cm to 18.0 cm × 16.0 era. The length of fibular transplantation ranged from 10 cm to 24 cm. 30 cases were combined in parallel connection transfer, 6 cases were combined in series connection transfer, 5 cases were repaired in emergency, 5 cases were repaired in subemergency, 26 cases were repaired in delay. Results All cases were successfully repaired in 36 cases.35 cases were followed up. A mean follow-up was 29 months. Arterial crisis occurred in 1 case, venous crisis occurred in 2 cases 34 flaps survived completely and 2 cutaneous fibular flap survived partially in parallel connection which were later healed by skin transplantation.32 cases were healed in first stage, 4 cases were healed in second stage, (healing time ranged from 12 to 18 days), Bone healing time ranged from 3 to 6 months in fibula transplantation. The Enneking score system was applied to evaluate the leg function. Of the 35 cases, the mean scores was 26 (their scores ranged from 23 to 28).The functions of all supplied regions were not found malfunctional. Conclusion Transplantation of the cutaneous fibular flap combined with anterolateral thigh flap is an optimal method to repair the complex tissue defect of the leg.
