CAJ | 학술논문

目的探讨游离背阔肌肌皮瓣修复膝关节周围大范围皮肤软组织深度缺损的疗效.方法 2005年3月-2014年3月,笔者单位收治膝关节周围大范围皮肤软组织深度缺损患者25例,缺损面积10 cm×8 cm～43 em×23 cm.采用游离背阔肌肌皮瓣修复,肌皮瓣面积12 cm×10 cm～45 cm×25 cm.肌皮瓣携带的胸背动静脉分别与患肢旋股外侧动静脉降支吻合,重建血运;取供瓣区周围刃厚皮覆盖肌皮瓣中未携带皮肤的肌肉表面.供瓣区直接缝合,供皮区予换药处理.结果术后25例患者皮瓣均完全成活,无一例出现血管危象,创面外观较佳.供瓣区均愈合,遗留线状瘢痕.术后随访3～6个月,患者均能站立及行走.结论游离移植背阔肌肌皮瓣是修复膝关节周围大范围皮肤软组织深度缺损的较好方法,旋股外侧动静脉降支是受区血管的较佳选择.
목적 탐토유리배활기기피판수복슬관절주위대범위피부연조직심도결손적료효.방법 2005년3월-2014년3월,필자단위수치슬관절주위대범위피부연조직심도결손환자25례,결손면적10 cm×8 cm～43 em×23 cm.채용유리배활기기피판수복,기피판면적12 cm×10 cm～45 cm×25 cm.기피판휴대적흉배동정맥분별여환지선고외측동정맥강지문합,중건혈운;취공판구주위인후피복개기피판중미휴대피부적기육표면.공판구직접봉합,공피구여환약처리.결과 술후25례환자피판균완전성활,무일례출현혈관위상,창면외관교가.공판구균유합,유류선상반흔.술후수방3～6개월,환자균능참립급행주.결론 유리이식배활기기피판시수복슬관절주위대범위피부연조직심도결손적교호방법,선고외측동정맥강지시수구혈관적교가선택.
Objective To investigate the clinical efficacy of free latissimus dorsi musculocutaneous flaps in repairing large and deep skin and soft tissue defects around the knee joints.Methods Twentyfive patients with large and deep skin and soft tissue defects around the knee joints were hospitalized from March 2005 to March 2014.The area of defects around the knee joints ranged from 10 cm × 8 cm to 43 cm × 23 cm.The free latissimus dorsi musculocutaneous flaps were used to repair the defects, with the area ranging from 12 cm × 10 cm to 45 cm × 25 cm.The thoracodorsal artery and its concomitant vein of the musculocutaneous flap were anastomosed to the descending branch of the lateral circumflex femoral artery and its concomitant vein respectively to reconstruct blood supply.Split-thickness skin grafts around the flap donor sites were harvested to cover the muscle surface of the musculocutaneous flaps.The flap donor sites were closed directly with suture, and the skin donor sites were healed by dressing change.Results All the 25 flaps survived without vascular crisis.The flaps were in satisfactory appearance.The flap donor sites were healed with linear scar.All the patients were followed up for 3 to 6 months.At last, they were able to stand up and walk.Conclusions The free latissimus dorsi musculocutaneous flap transplantation is an effective treatment for the repair of large and deep soft tissue defects around the knee joints, and the descending branch of lateral circumflex femoral artery and its concomitant vein are the appropriate recipient vessels.