离断肢体合并大面积软组织缺损的皮瓣修复

Microsurgerical renovation of the amputated limbs with serious soft tissue defects

目的报道应用大型肌皮瓣一期或二期修复断肢合并大面积软组织缺损的临床效果。方法对9例由压砸、捻挫或撕脱造成肢体离断合并皮肤软组织缺损的患者,再植后,应用游离或带蒂的胸脐、脐旁皮瓣,小腿内侧皮瓣、小腿外侧骨皮瓣,游离背阔肌皮瓣进行修复。结果9例患者皮瓣及再植肢体全部成活,随访10个月～4年,皮瓣外观质地良好,再植肢体恢复了一定功能。结论应用组织瓣移植对复杂性断肢合并组织缺损进行修复和重建疗效可靠。

Objective To report the clinical effect of using the large scale myocutaneous flaps to repair the amputated limbs with serious soft tissue defects.Methods For 9 limbs amputated cases with soft tissue defects because of contusion or avulsive injury.We renovated them with the free or pediceled chest-navel flap,the flap of the leg and the free latissimus dorsal muscular flap after replantation.Results All the cases were followed up from 10 months to 4 years,the amputated limbs and flaps survived,the appearances and function of the limbs were satisfactary.Conclusion The method of renovating the amputated limbs with tissue defect by transplanting tissue flaps is practical and efficient.