儿童游离组织瓣修复组织缺损27例的临床分析

Clinical analysis of microsurgical free tissue flap transfers in pediatric reconstruction of various defects

目的 探讨游离组织瓣对儿童组织缺损修复的临床效果,并对其安全性和可靠性进行初步分析. 方法 2004年1月至2011年12月,应用游离组织瓣对27例儿童患者进行组织修复.男14例,女13例：年龄5 ～14岁,平均10.8岁.肿瘤切除后修复5例,创伤后缺损16例,烧伤后瘢痕6例,游离皮瓣19例,游离肌骨瓣6例,游离肌瓣2例,平均手术时间4 h 20 min. 结果 术后仅1例发生皮瓣部分坏死,其余组织瓣均存活,成功率达96.3％,术后患者均获随访,随访时间3个月至4年（平均随访1.5年）,患处组织瓣外形稍臃肿,色泽、质地满意. 结论 对儿童患者的软组织及骨组织缺损进行游离组织瓣移植修复是一种安全可靠的方法.

Objective To investigate the clinical results of microsurgical free tissue transfers in pediatric reconstruction.Methods Between Janua~ 2004 and December 2010,twenty-seven free tissue transfers for reconstruction of various defects in 27 pediatric patients were performed.The average age at the time of reconstruction was 10.8 years（range：5-14 years）.Fourteen patients were boys and 13 were girls.There were 5 tumor resection defects,sixteen posttraumatic defects and 6 burn contractures which consist of 19 fasciocutaneous flaps,six osteoseptocutaneous flaps and 2 muscle flaps.The mean operative time was 4 hours and 20 minutes.Results All flaps survived except 1 partial necrosis,with 96.3% success rate.All patients were followed up 3 months to 4 years （mean,one and a half years）.The appearance of the flaps was slightly overstaffed,but the color and texture were satisfactory.Conclusion Free tissue flap transfer is a safe,reliable,cost-and time-effective method for the reconstruction of various defects in children.