Hanasono Matthew M, Skoracki Roman J
Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Ann Plast Surg. 2007 May;58(5):573-6. doi: 10.1097/01.sap.0000237638.93453.66.
We performed microvascular free muscle flaps on 5 patients using the vacuum-assisted closure (VAC) device (KCI, San Antonio, TX) to secure a split-thickness skin graft to the external surface of the flap in each case. This method of skin-graft fixation was selected in each case because of the complex 3-dimensional shape of the flap or because of concerns of inadequate fixation provided by conventional tie-over bolster techniques in regions that experience a significant amount of shear stress. All 5 flaps remained viable throughout the treatment course and all 5 patients experienced excellent skin-graft take. Also, decreased edema was noted in all 5 flaps. We conclude that the VAC device is a useful tool in the fixation of skin grafts to microvascular free flaps and that its use does not compromise free-flap viability.
我们对5例患者实施了微血管游离肌皮瓣手术，术中使用负压封闭引流（VAC）装置（KCI公司，得克萨斯州圣安东尼奥市），以便在每种情况下将中厚皮片固定于皮瓣外表面。由于皮瓣的三维形状复杂，或担心在承受大量剪切力的区域常规的打包加压技术固定不充分，在每种情况下均选择了这种皮片固定方法。在整个治疗过程中，所有5个皮瓣均保持存活，所有5例患者的皮片均顺利成活。此外，所有5个皮瓣的水肿均有所减轻。我们得出结论，VAC装置是将皮片固定于微血管游离皮瓣的一种有用工具，且其使用不会损害游离皮瓣的存活能力。
