Thornton Brian P, Rosenblum William J, Pu Lee L Q
Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
Ann Plast Surg. 2005 Mar;54(3):276-80.
This study was conducted to analyze the cost and outcome of free-tissue transfers versus local muscle flaps for reconstruction of limited soft-tissue defects associated with tibial fractures in the distal third of the leg. Twelve adult patients underwent either free (n = 6) or local muscle (n = 6) flap reconstruction were retrospectively reviewed. Total operative time for local muscle flap reconstruction was 215 +/- 47 minutes compared with 450 +/- 90 minutes (P < 0.0002) for free-muscle transfer. Median length of hospital stay after reconstruction was 7 days for local muscle flap compared with 9 days for free-muscle transfer. Total cost of the local muscle flap procedure was US dollars 11,729 +/- US dollars 4460 compared with US dollars 19,989 +/- US dollars 3295 (P < 0.0004) for free-flap reconstruction. Five of 6 patients in each group had excellent soft-tissue contours. Fracture healing was evident in all patients of each group. Thus, a local muscle flap for reconstruction of a limited distal tibial wound appears to be more cost-effective than free-tissue transfer because of equivocal outcomes achieved but at approximately half of the cost.
本研究旨在分析游离组织移植与局部肌皮瓣移植修复小腿远端三分之一胫骨骨折相关有限软组织缺损的成本和效果。回顾性分析了12例接受游离（n = 6）或局部肌皮瓣（n = 6）重建的成年患者。局部肌皮瓣重建的总手术时间为215±47分钟，而游离肌皮瓣移植为450±90分钟（P < 0.0002）。重建后局部肌皮瓣组的中位住院时间为7天，游离肌皮瓣移植组为9天。局部肌皮瓣手术的总成本为11,729±4460美元，而游离瓣重建为19,989±3295美元（P < 0.0004）。每组6例患者中有5例软组织轮廓良好。每组所有患者骨折均愈合。因此，由于效果相当，但成本约为游离组织移植的一半，局部肌皮瓣修复小腿远端有限伤口似乎更具成本效益。
