Khouri R K, Upton J
Division of Plastic Surgery, Beth Israel Hospital, Boston, MA.
Ann Plast Surg. 1991 Dec;27(6):574-6. doi: 10.1097/00000637-199112000-00011.
A patient with long-standing bilateral circumferential lower extremity sickle cell ulcerations refractory to conservative management was successfully treated with bilateral free latissimus muscle transfers. This report confirms the value of free tissue transfer in the treatment of these difficult skin ulcerations. Exchange transfusions that brought the SS hemoglobin below 30% were crucial to the prevention of sickling in the microcirculation of the flap during its obligate period of ischemia. Furthermore, they protected the flap during a period of ischemia that exceeded 4 hours following a postoperative arterial thrombosis. In the presence of severe thrombocytosis associated with sickle cell disease, prophylactic treatment with aspirin may be of significant value.
一名长期患有双侧下肢环形镰状细胞溃疡且保守治疗无效的患者，通过双侧游离背阔肌转移术成功治愈。本报告证实了游离组织转移在治疗这些难治性皮肤溃疡中的价值。将SS血红蛋白降至30%以下的换血疗法对于在皮瓣缺血的必要阶段预防微循环中的镰状化至关重要。此外，在术后动脉血栓形成后超过4小时的缺血期内，它们保护了皮瓣。在镰状细胞病相关的严重血小板增多症存在的情况下，阿司匹林预防性治疗可能具有重要价值。
