Molski M, Potocki K, Stańczyk J, Komorowska A, Murawski M
Klinika Chirurgii Plastycznej, Centrum Medyczne Kształcenia Podyplomowego w Warszawie.
Chir Narzadow Ruchu Ortop Pol. 2000;65(6):611-7.
In the years 1981-1997 at the Department of Plastic Surgery Medical Centre for Postsgraduate Education in Warsaw 116 patients were treated surgically using groin flaps and 97 patients using a pedicled cutaneous groin flap. This paper reports the results of the later technique. Reconstructions were performed in 10 female patients aged 18-58 (mean age 37.5 years) and 87 male patients aged 15-67 (mean age 33.8 years). The tissue defects or acquired deformations were caused by: crush injuries (26 cases), scalping injuries (23 cases), rugged injuries (18 cases), avulsion trauma (15 cases), explosion injuries (8 cases) and electric burns (7 cases). Flap size depended upon extent of the tissue defect and the from flaps were 7-26 cm long and 4-12 cm wide. Flap area ranged from 35 to 260 square centimetres. Emergency procedures were performed in 59 patients (61%). Secondary reconstructions were carried out in 38 cases (39%). Operative technique was based on the rules described by McGregor and Jackson. The donor site was sutured primarily tubulizing its basis--as in tube flap. The flap pedicle was cut off during a one stage procedure in 41 patients 21-30 days (mean 23 days) after surgery or during a two-stage procedure in 56 cases. The two-stage procedure consisted of an incision of part of the pedicle after 15-45 days post-op (mean 21 days) followed by a complete dissection after a few days (mean 4 days). In 44 cases the flap required modelling i.e. excision of excessives kin and/or thinning of subcutaneous tissue. The flap healed in 96 patients (99%). Complications at different stages of the treatment were observed in 40 patients (41%). In 3 cases wound ischemia was observed because of too tight suturing. Removal of skin sutures lead to normalization of blood supply. In 7 patients cyanotic skin of the distal part with no significant consequences was observed. In 27 patients (28%) necrosis of the marginal tissues surrounding the operation wound after cutting of the pedicle was noted. Besides supported necrectomy a conservative treatment was also applied by putting dressings soaked with antiseptics and 0.5% neomycine solution on a daily basis. This prolonged treatment by further several weeks. No significant complications were observed at the donor site.
1981年至1997年期间，在华沙研究生教育医学中心整形外科，116例患者接受了腹股沟皮瓣手术治疗，97例患者接受了带蒂腹股沟皮瓣手术治疗。本文报告了后一种技术的结果。对10名年龄在18至58岁（平均年龄37.5岁）的女性患者和87名年龄在15至67岁（平均年龄33.8岁）的男性患者进行了重建手术。组织缺损或后天畸形由以下原因引起：挤压伤（26例）、头皮撕脱伤（23例）、粗糙伤（18例）、撕脱伤（15例）、爆炸伤（8例）和电烧伤（7例）。皮瓣大小取决于组织缺损的程度，皮瓣长度为7至26厘米，宽度为4至12厘米。皮瓣面积为35至260平方厘米。59例患者（61%）进行了急诊手术。38例患者（39%）进行了二期重建。手术技术基于麦格雷戈和杰克逊描述的规则。供区主要进行管状缝合——如同管状皮瓣那样。41例患者在术后21至30天（平均23天）的一期手术中切断皮瓣蒂部，56例患者在二期手术中切断。二期手术包括术后15至45天（平均21天）切开部分蒂部，几天后（平均4天）进行完全切断。44例患者的皮瓣需要塑形，即切除多余的皮肤和/或皮下组织变薄。96例患者（99%）的皮瓣愈合。40例患者（41%）在治疗的不同阶段出现了并发症。3例患者因缝合过紧出现伤口缺血。拆除皮肤缝线后血供恢复正常。7例患者观察到远端皮肤发绀，但无明显后果。27例患者（28%）在切断蒂部后手术伤口周围边缘组织出现坏死。除了支持性清创术外，还通过每天敷用浸有防腐剂和0.5%新霉素溶液的敷料进行保守治疗。这种延长的治疗又持续了几周。供区未观察到明显并发症。
