受区炎性疤痕吻合血管游离皮瓣移植术中的手术要点

目的:探讨受区炎性疤痕吻合血管游离皮瓣移植手术的成功率。方法:受区炎性疤痕,需行游离皮瓣修复10例,其中桥式交叉吻合3例,血管移植4例,扩大清创至正常区域吻合3例。结果:所有皮瓣均完全存活,未出现血管危象,术后功能恢复良好。结论:受区慢性感染所致的炎性疤痕内的血管不可行血管吻合,吻合处应位于正常组织内,以提高皮瓣存活率,减少术后血管危象发生。

Obhectuve In the reconstruction with free flap of anastomosed blood vessel, correct judgment and disposal of the vascular pedicle in inflammatory scar tissue of recipient regiom will be advantageous to increase the rate of success of operatiom. Methods From July, 2005 to July, 2010, 12 case reconstruction with free flap have been finished ： In which the vascular pedicles of the recipient region in inflammatory scar tissue were disposed differently, including 1 cases of bridge cross, 3 cases of vascular grafting and 3 cases of vascular anastomosis at normal area followed by enlarging debridement. Results The operations were all successful on their first without the plstoperatine vascular crisis. Conclusion The blood vessel pedicle of the recipient region of inflammatory scar caused by chronic infection can not be used to anastomse. The vascular anastomosis must be performed at the normal tissue area so as to increase the survival ratio of free flap and decrease the postoperative vascular crisis