Liau James E, Pu Lee L Q
Division of Plastic Surgery, University of Kentucky, Lexington, USA.
Microsurgery. 2007;27(6):548-52. doi: 10.1002/micr.20402.
Despite recent advances in free tissue transfer, management of a large upper tibial wound extending to the knee can be challenging for reconstructive surgeons. In this report, we present two cases where a free latissimus dorsi flap was used for successful soft-tissue coverage of the wound for limb salvage with optimal reconstructive outcomes. Our unique recipient vessel selection allows more effective free-tissue transfer without using a vein graft. Our preferred flap inset technique with multiple interrupted horizontal mattress sutures over a closed suction drain leads to an improvement of the initial contour of soft-tissue coverage that may contribute to the final optimized outcome in the lower-extremity reconstruction with or without a further debulking procedure.
尽管近期在游离组织移植方面取得了进展，但对于重建外科医生而言，处理延伸至膝关节的大型胫骨上段伤口仍具有挑战性。在本报告中，我们呈现了两例使用背阔肌游离皮瓣成功覆盖伤口以挽救肢体并获得最佳重建效果的病例。我们独特的受区血管选择方法无需使用静脉移植即可实现更有效的游离组织移植。我们首选的皮瓣植入技术是在闭式负压引流管上方使用多根间断水平褥式缝线，这有助于改善软组织覆盖的初始外形，无论是否进行进一步的减容手术，都可能为下肢重建带来最终的优化效果。
