CAJ | 학술논문

目的探讨游离皮瓣修复胫前中上段大面积皮肤软组织缺损时吻合受区隐血管的可行性.方法 2009年6月-2014年4月,收治伴有胫前中上段大面积皮肤软组织缺损患者16例,其中男10例,女6例;年龄24～ 56岁,平均34.5岁,经全身支持治疗并多次清创结合VSD治疗后行创面修复手术,术前均设计采用吻合隐血管的游离股前外侧皮瓣移植修复. 结果 14例按术前设计进行,2例改用吻合健侧胫后血管的交腿皮瓣修复(1例隐动脉管径过细,1例隐动脉长段损伤变性栓塞,均不适合行血管吻合),14例吻合隐血管的皮瓣全部成活,其中12例一期愈合,2例皮瓣远端尖部部分坏死,经换药后逐渐愈合.13例经过6个月～2年随访,皮瓣外观无臃肿、质地优良,软组织缺损创面修复满意. 结论胫前中上段大面积皮肤软组织缺损的游离皮瓣移植修复可选择吻合受区隐血管.
목적 탐토유리피판수복경전중상단대면적피부연조직결손시문합수구은혈관적가행성.방법 2009년6월-2014년4월,수치반유경전중상단대면적피부연조직결손환자16례,기중남10례,녀6례;년령24～ 56세,평균34.5세,경전신지지치료병다차청창결합VSD치료후행창면수복수술,술전균설계채용문합은혈관적유리고전외측피판이식수복. 결과 14례안술전설계진행,2례개용문합건측경후혈관적교퇴피판수복(1례은동맥관경과세,1례은동맥장단손상변성전새,균불괄합행혈관문합),14례문합은혈관적피판전부성활,기중12례일기유합,2례피판원단첨부부분배사,경환약후축점유합.13례경과6개월～2년수방,피판외관무옹종、질지우량,연조직결손창면수복만의. 결론 경전중상단대면적피부연조직결손적유리피판이식수복가선택문합수구은혈관.
Objective To explore the feasibility of repairing the large area skin and soft tissue defect in thefront upper of tibia by free flap with anastomosis of saphenous vessels.Methods From June,2009 to April,2014,16 cases (10 males and 6 females) of large area skin and soft tissue defect in the front upper of tibia were treatedwith free flap.The ages ranged from 24 to 56 years old,averaged of 34.5 years old.The supportive therapy and repeated debridement combined with VSD,and designed to use free anterolateral thigh flap with anastomosis of saphenous vessels before repairing operation.Results Fourteen patients accorded with preoperative design,in which 2 cases were adopted cross leg flap anastomosis posterior tibia vessels of the healthy side (1 case of saphenous artery diameter too small,and 1 case of saphenous artery long injury degeneration,unsuitable for vascular anastomosis).All 14 flaps survived,expect 2 cases were part-necrosis in the end of the flap,and gradually healed by dressing exchange.Conclusion Reconstruction of large area skin and soft tissue defect in the front upper of tibia with free flap can use anastomosis of saphenous vessels.