CAJ | 학술논문

目的探讨大面积深度烧伤后期伴骨关节外露创面的修复方法. 方法 2009年1月-2011年5月,在笔者单位收治的大面积深度烧伤患者中,有5例于治疗后期伴有单个或多个骨关节外露,无法通过游离植皮或皮瓣修复.其中3例伴单个骨关节外露,2例伴2处以上骨关节及肌腱外露,创面大小为8 cm ×5cm～21 cm×8 cm.先后进行游离肌瓣复合刃厚皮(头皮)移植7例次,其中腹直肌肌瓣游离移植4例次、背阔肌肌瓣游离移植3例次.结果所有游离肌瓣及植皮均成活良好,骨关节外露创面完全修复,术后1年随访部分患者,修复部位外观良好,无溃疡、关节炎、骨髓炎等表现,关节功能正常.结论游离肌瓣复合头皮移植,能够为深度组织外露且缺乏供瓣区的患者提供有效的创面修复方法.
목적 탐토대면적심도소상후기반골관절외로창면적수복방법. 방법 2009년1월-2011년5월,재필자단위수치적대면적심도소상환자중,유5례우치료후기반유단개혹다개골관절외로,무법통과유리식피혹피판수복.기중3례반단개골관절외로,2례반2처이상골관절급기건외로,창면대소위8 cm ×5cm～21 cm×8 cm.선후진행유리기판복합인후피(두피)이식7례차,기중복직기기판유리이식4례차、배활기기판유리이식3례차.결과 소유유리기판급식피균성활량호,골관절외로창면완전수복,술후1년수방부분환자,수복부위외관량호,무궤양、관절염、골수염등표현,관절공능정상.결론 유리기판복합두피이식,능구위심도조직외로차결핍공판구적환자제공유효적창면수복방법.
Objective To explore the means for the reconstruction of extensive deep burn wounds with exposure of bone and joint in late stage.Methods Among all the patients with extensive deep burn hospitalized between January 2009 and May 2011,5 patients presented wounds with exposure of bone and joint in the late stage of treatment that could not be covered by free skin grafts or flaps.Two of the five patients had more than 2 and the other 3 patients had only one such wound (s).The wound size ranged from 8 cm ×5 cm to 21 cm ×8 cm.Wounds were repaired by transplantation of 7 free muscle flaps (including 4 free rectus abdominis flaps and 3 latissimus dorsi flaps) combined with split-thickness skin grafts harvested from scalp.Results All the muscle flaps and skin grafts survived.Wounds with bone and joint exposure healed well.At one-year follow-up of some patients,good appearance of repaired areas and normal function ofjoints were observed with no signs of ulceration,arthritis,or osteomyelitis.Conclusions Transplantation of free muscle flaps combined with split-thickness skin grafts harvested from the scalp provides satisfactory reconstruction for wounds with deep tissue exposure in patients with a shortage of skin donor site.