CAJ | 학술논문

目的探讨游离腹壁下动脉嵌合穿支皮瓣修复合并深部死腔的下肢创面的可行性及临床效果.方法 2010年3月至2011年8月,采用游离腹壁下动脉嵌合穿支皮瓣修复下肢皮肤软组织缺损8例,分别伴有不同程度的死腔、骨缺损或骨关节外露.其中肌瓣填塞深部死腔,穿支皮瓣覆盖浅表创面.皮瓣供区直接缝合.结果术后所有皮瓣均顺利存活,皮瓣受区与供区均一期愈合.术后随访12～ 24个月,平均16个月,所有皮瓣颜色、质地好,其中2例皮瓣继发肥厚,行皮瓣修薄术.皮瓣供区仅留线性瘢痕,腹壁功能无影响.结论游离腹壁下动脉嵌合穿支皮瓣只需吻合1组血管蒂,能同时修复深部死腔和体表创面,提高了受区的修复质量,减少供区损害,是修复合并深部死腔创面的较为理想的方法.
목적 탐토유리복벽하동맥감합천지피판수복합병심부사강적하지창면적가행성급림상효과.방법 2010년3월지2011년8월,채용유리복벽하동맥감합천지피판수복하지피부연조직결손8례,분별반유불동정도적사강、골결손혹골관절외로.기중기판전새심부사강,천지피판복개천표창면.피판공구직접봉합.결과 술후소유피판균순리존활,피판수구여공구균일기유합.술후수방12～ 24개월,평균16개월,소유피판안색、질지호,기중2례피판계발비후,행피판수박술.피판공구부류선성반흔,복벽공능무영향.결론 유리복벽하동맥감합천지피판지수문합1조혈관체,능동시수복심부사강화체표창면,제고료수구적수복질량,감소공구손해,시수복합병심부사강창면적교위이상적방법.
Objective To explore the feasibility and the effect of free chimeric perforator flap with deep inferior epigastric artery for the soft tissue defect on the lower extremity with deep dead space.Methods From Mar.2010 to Aug.2011, 8 patients with soft tissue defects on the lower extremities combined with dead space, bone or joint exposure were reconstructed with free hinged perforator flaps with deep inferior epigastric artery.The muscle flap was inserted into the deep dead space, with perforator flap for superficial defect.The defects on the donor sites were closed directly.Results All the flaps survived with primary healing.Good color and texture was achieved.The patients were followed up for 12-24 months, with an average of 16 months.2 over-thick flaps were treated by flap-thinning surgery.Only linear scar was left on the donor site on abdomen with no malfunction.Conclusions The free chimeric perforator flap with deep inferior epigastric artery can simultaneously construct the dead space and superficial defect with only anastomosis of one set of vascular pedicle.It is an ideal method with good results on recipient sites and less morbidity on donor sites.