CAJ | 학술논문

目的：探讨急诊游离髂骨骨皮瓣一期修复下肢骨皮肤缺损的优点和可行性，并总结其疗效。方法对6例不同损伤原因造成的下肢部分骨质缺损，伴有不同程度的皮肤损伤，采用急诊游离髂骨骨皮瓣一期修复。皮肤缺损面积5.0 cm×6.0 cm~7.0 cm×12.0 cm，骨质缺损3.0 cm×5.0 cm~4.5 cm×5.5 cm，皮瓣面积6.0 cm×9.0 cm~7.0 cm×14.0 cm，骨质切取面积3.0 cm×6.0 cm~5.0 cm×6.0 cm，皮瓣供区全部直接缝合。结果移植骨皮瓣全部成活，术后伤口一期愈合。随访2~16个月（平均10个月），所有病例骨折均愈合，临床愈合时间6~8周，骨性愈合时间7~10个月。移植骨均未见吸收，未见骨不连及再骨折。移植皮瓣外形良好，二次修薄2例。皮瓣无色素沉着和增生性瘢痕。下肢行走良好。供区一期愈合。结论急诊游离髂骨骨皮瓣修复下肢骨皮肤缺损，一期修复骨质和皮肤缺损，减少住院天数和住院费用，骨愈合快，获得精细的专科修复。
목적：탐토급진유리가골골피판일기수복하지골피부결손적우점화가행성，병총결기료효。방법대6례불동손상원인조성적하지부분골질결손，반유불동정도적피부손상，채용급진유리가골골피판일기수복。피부결손면적5.0 cm×6.0 cm~7.0 cm×12.0 cm，골질결손3.0 cm×5.0 cm~4.5 cm×5.5 cm，피판면적6.0 cm×9.0 cm~7.0 cm×14.0 cm，골질절취면적3.0 cm×6.0 cm~5.0 cm×6.0 cm，피판공구전부직접봉합。결과이식골피판전부성활，술후상구일기유합。수방2~16개월（평균10개월），소유병례골절균유합，림상유합시간6~8주，골성유합시간7~10개월。이식골균미견흡수，미견골불련급재골절。이식피판외형량호，이차수박2례。피판무색소침착화증생성반흔。하지행주량호。공구일기유합。결론급진유리가골골피판수복하지골피부결손，일기수복골질화피부결손，감소주원천수화주원비용，골유합쾌，획득정세적전과수복。
Objective To research the advantages and feasibility of using the free cutaneous iliac flap to repair the defect on legs in emergency treatment in the first period, and summarizing its effect. Methods For 5 patients of leg injury caused by different reasons, using the free cutaneous iliac flap to repair the defect on legs in emergency treatment in the first period. The injury mainly led to partial bone defect on legs, with cutaneous injury in varied degree. It was estimated that cutaneous necrosis will happen after surgery and scar will be left after debridement. The area of skin defect was about 5 cm×6 cm~7 cm×12 cm. Bone defect was about 3.0 cm×5.0 cm~4.5 cm×5.5 cm, and the area of flap was about 6 cm×9 cm~7 cm×14 cm. bone cutting area was about 3.0 cm ×6.0 cm~5.0 cm ×6.0 cm, cutaneous graft was sutured directly. Results Transplanted iliac flap all survived, the wound healed in the first period after the surgery. Following up 2~16 months (10 months on average), fractures of all cases healed. Clinical healing time was 6~8 weeks. The bone graft healed with the host bone in 7~10 months on average. The bone graft was not seen to be absorbed. No nonunion and re-fracture was seen. Transplanted flap was in good shape. There were 2 cases of second-thining. There was no pigementation and hyperplastic scar. Patients walked well with their legs. Donor site healed in the first period. Conclusion Using free cutaneous iliac flap to repair the defect of the legs in emergency treatment, bone and cutaneous defect healed in the first period, decreasing the time of patients in hospital. Bone heals fast, getting fine special repairing.