CAJ | 학술논문

目的探讨应用带蒂胫骨皮瓣移植修复小腿严重的创伤性感染性骨和软组织缺损的临床疗效. 方法白2007年8月至2013年11月,对27例小腿创伤性感染性骨与皮肤软组织缺损采用带蒂胫骨皮瓣移植治疗,重建患肢胫骨连续性及覆盖创面.本组年龄21 ～ 54岁,平均33岁;皮肤软组织缺损5.0cm× 8.5 cm ～ 7.4 cm× 16.0 cm,骨缺损长度5.0 ～ 16.0 cm.胫骨皮瓣面积最小6.0 cm×10.0 cm,最大10.0 cm× 18.0 cm,骨瓣最长为18.0 cm. 结果 1例皮瓣因血液循环障碍出现部分坏死,断蒂时行临近皮瓣推进修复,其余26例皮瓣完全成活,经6个月～4年的随访,患肢感染得到完全控制,功能及外形恢复良好.结论带蒂胫骨皮瓣血供丰富、皮瓣面积大、骨瓣长度长,可一次性修复小腿长段骨及大面积软组织缺损,完成骨结构重建及创面覆盖,缩短病程,利于患肢功能尽快恢复.
목적 탐토응용대체경골피판이식수복소퇴엄중적창상성감염성골화연조직결손적림상료효. 방법 백2007년8월지2013년11월,대27례소퇴창상성감염성골여피부연조직결손채용대체경골피판이식치료,중건환지경골련속성급복개창면.본조년령21 ～ 54세,평균33세;피부연조직결손5.0cm× 8.5 cm ～ 7.4 cm× 16.0 cm,골결손장도5.0 ～ 16.0 cm.경골피판면적최소6.0 cm×10.0 cm,최대10.0 cm× 18.0 cm,골판최장위18.0 cm. 결과 1례피판인혈액순배장애출현부분배사,단체시행림근피판추진수복,기여26례피판완전성활,경6개월～4년적수방,환지감염득도완전공제,공능급외형회복량호.결론 대체경골피판혈공봉부、피판면적대、골판장도장,가일차성수복소퇴장단골급대면적연조직결손,완성골결구중건급창면복개,축단병정,리우환지공능진쾌회복.
Objective To explore the outcome of the tibial bone-skin flap grafts in the management of severe traumatic osteomyelitis complicated with bone and skin defect in leg.Methods Twenty-seven cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap grafe from August, 2007 to November, 2013.Reconstruction of limb tibia continuity and cover the wound.Results The tibial bone-skin flaps were completely survived in 26 of the 27 cases except 1 ease which was repaired by adjacent flap because of the disorder blood circulation.The followed-up showed that all flaps had good blood circulation.The infection was controlled completely.The leg function and contour were satisfactory.Conclusion The tibial boneskin flap has the advantages of abundant blood supply, full bone-skin flap supply, shortens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.