Hallock G G
Division of Plastic Surgery, Allentown Hospital-Lehigh Valley Hospital Center, Pa.
Plast Reconstr Surg. 1992 Oct;90(4):629-35. doi: 10.1097/00006534-199210000-00012.
The majority of acute burn wounds or delayed reconstructions are best managed simply with a skin graft. However, if vascularized tissue is mandatory, the local fasciocutaneous flap may have an important role in providing a single-stage technique for obtaining tissue nearly identical in color, texture, and consistency to that of the defect being restored. This review of 182 consecutive burn patients needing surgery found that they underwent 233 separate episodes for skin grafting. Appropriately, only a fraction of this number required some form of vascularized flap, with 14 patients having 21 local fasciocutaneous flaps. Six were elevated in previously skin-grafted regions, which is an advantage peculiar to this flap type. Three flaps (14 percent) suffered major complications requiring a second surgical intervention. Only six of all flaps were used for acute burn wounds, but two of the three complications accrued in this subset, with one directly attributable to wound infection. Since most flaps were required for either coverage or release of contractures about joints, it has been recommended that the initial surgical approach for treatment of the acute wound in these regions be altered to preserve the fascial plexus whenever possible to permit the use of this simple and expedient alternative if it is needed later.
大多数急性烧伤创面或延迟重建最好仅通过植皮来处理。然而，如果必须使用带血管组织，局部筋膜皮瓣可能在提供一种单阶段技术方面发挥重要作用，该技术可获得颜色、质地和质地与待修复缺损几乎相同的组织。对182例连续需要手术的烧伤患者进行的这项回顾发现，他们接受了233次单独的植皮手术。恰当地说，其中只有一小部分需要某种形式的带血管皮瓣，14例患者使用了21个局部筋膜皮瓣。6个皮瓣是在先前植皮的区域掀起的，这是这种皮瓣类型特有的一个优点。3个皮瓣（14%）出现了需要二次手术干预的严重并发症。所有皮瓣中只有6个用于急性烧伤创面，但这一亚组中的3个并发症中有2个发生在这一亚组中，其中1个直接归因于伤口感染。由于大多数皮瓣用于覆盖或松解关节周围的挛缩，因此建议改变这些区域急性伤口的初始手术方法，尽可能保留筋膜丛，以便在以后需要时能够使用这种简单便捷的替代方法。
