游离股前外侧肌皮瓣治疗截肢术后残端坏死合并感染、骨外露

Using free Anterolateral Femoral Muscular Flap to Treat the Necrosis with Infection and Bone Exposure after Limb Amputation

目的:应用游离股前外侧肌皮瓣治疗截肢术后残端坏死合并感染、骨外露的临床疗效。方法:对四肢严重创伤行截肢,术后残端坏死合并感染、骨外露,设计游离股前外侧肌皮瓣治疗,其中急诊截肢7例,保肢失败而2期行截肢5例,创面面积最大50cmx45cm,最小10cmx7cm,肌皮瓣面积最大9cmx26cm,最小8 cmx12 cm。结果:术后12例肌皮瓣全部成活。供区无功能障碍,受区外形满意,安装假肢后功能良好。结论:应用游离股前外侧肌皮瓣治疗截肢术后残端坏死合并感染、骨外露,抗感染能力强,成功率高,避免再次截肢,可以最大限度地保留自身关节,改善假肢功能。

Objective ： To report the clinical effects of using free anterolateral femoral muscular flap to treat the necrosis with infection and bone exposure after limb amputation. Methods： We designed free anterolateral femoral muscular flap to treat 12 patients with the necrosis of infection and bone exposure after undergoing the limb amputation due to severe trauma, 7 cases underwent emergency operations and 5 cases underwent secondary operations. The soft tissue defect scale was from 50cm×45cm to 10cm×7cm, The maximum scale of the muscular flap was 9cm×26cm, the minimum scale was 8cm×12cm. Results： All cases were successful.No drawback of the donate area, the figure of the nubs was satisfied, and the function was approval. Conclusion： Free anterolateral femoral muscular flap reconstructing the necrosis with infection and bone exposure after limb amputation is an effective method of anti-infection ability, and has high successful rate and improve the function of the artificial limb.