CAJ | 학술논문

目的：介绍胸脐皮瓣游离移植修复小腿软组织缺损的方法和体会。方法本组共15例患者，男12例，女3例；年龄20～57岁，平均35岁。受伤原因：交通意外伤10例，压砸伤3例，机器绞伤2例。损伤部位：单纯小腿损伤的11例，合并足部（包括内、外踝）4例。所有的创面均伴有肌腱的损伤、外露或骨缺损、骨外露。皮肤组织缺损面积18 cm×13 cm～28 cm×16 cm。急诊手术3例，择期手术12例。采用游离胸脐皮瓣修复缺损。结果术后带蒂胸脐皮瓣全部成活；1例远端皮缘坏死，经换药处理后痊愈。其中创面一期愈合有12例，二期愈合3例。结论胸脐皮瓣质好，供皮面积大，有利于治疗大面积缺损的下肢创面。
목적：개소흉제피판유리이식수복소퇴연조직결손적방법화체회。방법본조공15례환자，남12례，녀3례；년령20～57세，평균35세。수상원인：교통의외상10례，압잡상3례，궤기교상2례。손상부위：단순소퇴손상적11례，합병족부（포괄내、외과）4례。소유적창면균반유기건적손상、외로혹골결손、골외로。피부조직결손면적18 cm×13 cm～28 cm×16 cm。급진수술3례，택기수술12례。채용유리흉제피판수복결손。결과술후대체흉제피판전부성활；1례원단피연배사，경환약처리후전유。기중창면일기유합유12례，이기유합3례。결론흉제피판질호，공피면적대，유리우치료대면적결손적하지창면。
Objective To introduce the method and experience of free thoracoumbilical flap for repairing soft tissue defect of lower extremities. Methods Fifteen patients (male 12 cases, female 3 cases, and aged 21-56 years old) with soft tissue defect of lower extremities were reported between 2009 and 2012, including 10 cases of traffic accident injury, 3 cases of crush injury and 2 cases of machine injury. Of 15 cases, the sites of the soft-tissue defects included shank region in 11 cases, lower leg (including internal, external malleolus) in 4 cases. The defect size was 18 cm × 13 cm in length to 28 cm × 16 cm in width. All soft tissue losses were filled with free thoraco-umbilical flap. Results All pedicled thoraco-umbilicus flaps survived. Vascular crisis postoperation occurred in one case due to arterial embolization in donor, and healed by autogenous vein graft. Distal part skin necrosis was found in one case and recovered after dressing change. Conclusion Free thoracoumbilical flap can supply a large and high quality skinflap for repairing soft tissue defect of compex extremity trauma.