CAJ | 학술논문

目的寻找应用背阔肌瓣游离移植修复下肢缺损的方法.方法 1996年2月-2008年2月,笔者单位应用游离背阔肌瓣修复下肢皮肤及组织缺损患者42例,其中膝部4例,小腿22例,足、踝部15例,膝下至足背严重撕脱1例.清创后采用背阔肌肌皮瓣、背阔肌肌瓣植皮、保留肌袖的背阔肌穿支皮瓣、分叶背阔肌组织瓣修复创面.组织瓣切取范围18 cm×8 cm～40 cm × 18cm.结果除3例患者术后发生血管危象,2例供区植皮和1例肌瓣植皮部分坏死外,其余患者创面均一次性愈合.随访3～24个月,6例患者皮瓣外形臃肿,影响穿鞋,再次行皮瓣修薄术;3例肌瓣植皮区有轻度瘢痕挛缩.结论个性化设计不同形式的背阔肌瓣,可满足下肢皮肤软组织缺损的修复.
목적 심조응용배활기판유리이식수복하지결손적방법.방법 1996년2월-2008년2월,필자단위응용유리배활기판수복하지피부급조직결손환자42례,기중슬부4례,소퇴22례,족、과부15례,슬하지족배엄중시탈1례.청창후채용배활기기피판、배활기기판식피、보류기수적배활기천지피판、분협배활기조직판수복창면.조직판절취범위18 cm×8 cm～40 cm × 18cm.결과 제3례환자술후발생혈관위상,2례공구식피화1례기판식피부분배사외,기여환자창면균일차성유합.수방3～24개월,6례환자피판외형옹종,영향천혜,재차행피판수박술;3례기판식피구유경도반흔련축.결론 개성화설계불동형식적배활기판,가만족하지피부연조직결손적수복.
Objective To explore repair methods of skin and soft tissue defects in lower extremities with free latissimus dorsi flaps. Methods Forty-two patients with wounds and soft tissue defects in lower extremities, including 4 cases on knee, 22 cases on leg, 15 cases on ankle and foot, 1 case with extensive a-vulsion from knee to dorsum of foot, were hospitalized in our unit from February 1996 to February 2008. Wounds or soft tissue defects were respectively repaired with latissimus dorsi musculoeutaneous flaps, latissi-mus dorsi muscle flaps, latissimus dorsi perforator flaps with preserved vascular sleeves, 2 double-leaf seg-mental latissimus dorsi compound flaps after debridement. The flaps ranged from 18 cm×8 cm to 40 cm×18 cm in size. The donor sites were covered by skin grafting in 19 cases. Results All wounds were healed primarily except vascular crisis occurred in 3 cases, partial necrosis of skin at donor site in 2 cases, and graft site(1 case). Follow-up for 3 to 24 months of 31 patients showed: six cases received two-stage plastic operation on account of bulkiness with trouble in wearing shoes, and mild contraction of muscular flap in 3 cases. Conclusions Latissimus dorsi flap in various forms can be satisfactory for repair of large skin and soft tissue defects in lower extremities.