Brüner Simone, Bickert Berthold, Sauerbier Michael, Germann Günter
Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center, University of Heidelberg, Ludwigshafen, Germany.
Microsurgery. 2004;24(2):104-13. doi: 10.1002/micr.20006.
The present study describes the concepts of arteriovenous (A-V) loupes prior to microsurgical free flap transfer in a selected high-risk group of patients. A one-stage concept was employed in 26 patients; 5 patients underwent two-stage flap transfer. Seven thrombotic occlusions of the A-V fistula or flap vessels were recorded; 6 patients underwent successful revision. Overall flap survival was 96.8% and compared favorably to reports in the literature. Defect coverage could be achieved in all but one case. It can be concluded from the data that in selected high-risk patient groups, i.e., following radiation, compound trauma, chronic infection, or multiple comorbidities, the creation of an A-V fistula prior to flap transfer may facilitate innovative reconstructive solutions.
本研究描述了在一组选定的高风险患者中，进行显微外科游离皮瓣移植前动静脉（A-V）放大镜的概念。26例患者采用一期概念；5例患者接受了二期皮瓣移植。记录到7例动静脉瘘或皮瓣血管血栓形成闭塞；6例患者成功进行了修复。总体皮瓣存活率为96.8%，与文献报道相比具有优势。除1例病例外，所有病例均实现了缺损覆盖。从数据中可以得出结论，在选定的高风险患者群体中，即放疗后、复合创伤、慢性感染或多种合并症患者中，皮瓣移植前建立动静脉瘘可能有助于创新的重建解决方案。
