Romeo Marco, Cuccia Giuseppe, Manasseri Benedetto, Delia Gabriele, Risitano Giovanni, Spinelli Francesco, D'Alcontres Francesco Stagno, Colonna Michele R
Department of Plastic Surgery and Vascular Surgery, Messina University Hospital, Messina, Italy.
Microsurgery. 2009;29(6):495-8. doi: 10.1002/micr.20630.
A case of challenging microsurgical reconstruction of a difficult defect in a radiated upper limb is reported. A difficult wound, with tendon and bone exposition, developed on the dorsum of the forearm in a 76-year-old patient; she had been radiated since almost 50 years and her left hand had also been revascularized twice with venous grafts between the humeral artery and the superficial palmar arch. After failure of a local flap, an anterior-lateral thigh perforator flap was successfully transferred with end-to-side anastomoses on the arterialized venous graft. Up to date follow-up shows a good outcome. The Authors discuss the case and review the indications for microsurgical reconstruction in difficult wounds after radiation and ischemic limb conditions.
报道了一例对上肢放疗后难愈缺损进行具有挑战性的显微外科重建的病例。一名76岁患者的前臂背侧出现了一个伴有肌腱和骨质外露的难愈伤口；她接受放疗已近50年，其左手还曾通过肱动脉与掌浅弓之间的静脉移植进行过两次血管重建。在局部皮瓣失败后，成功转移了股前外侧穿支皮瓣，并与动脉化静脉移植进行了端侧吻合。截至目前的随访显示效果良好。作者对该病例进行了讨论，并回顾了放疗后难愈伤口及肢体缺血情况下显微外科重建的适应症。
