Vaienti L, Menozzi A, Lonigro J, Soresina M, Ravasio G
Department of Plastic and Reconstructive Surgery, I.R.C.C.S. Policlinico San Donato, University of Milan, Via Morandi 30, 20097, San Donato, Milan, Italy.
Musculoskelet Surg. 2010 May;94(1):33-40. doi: 10.1007/s12306-010-0063-x. Epub 2010 Mar 5.
Prosthetic exposure is a severe complication of total knee arthroplasty. Many factors are responsible for failed wound healing, and successful salvage of total knee arthroplasty requires early identification of infection, antecedent events related with wound healing failure, aggressive surgical debridement and early appropriate soft-tissue coverage with local skin, fasciocutaneous, muscle, neurocutaneous or perforator flaps. In this report, we present 15 cases of exposed knee prosthesis treated with island sural neurocutaneous flap. Follow-up showed favorable clinical outcomes: all flaps survived and only two cases of hematoma and one of aseptic phystula occurred. According to our results, the island neurofasciocutaneous sural flap represents a sensate reconstructive alternative for providing fine and dependable soft tissue for covering skin defects around the knee.
假体暴露是全膝关节置换术的一种严重并发症。伤口愈合失败由多种因素导致，而成功挽救全膝关节置换术需要早期识别感染、与伤口愈合失败相关的先前事件、积极的手术清创以及早期用局部皮肤、筋膜皮瓣、肌皮瓣、神经皮瓣或穿支皮瓣进行适当的软组织覆盖。在本报告中，我们展示了15例采用腓肠神经岛状皮瓣治疗的膝关节假体暴露病例。随访显示临床效果良好：所有皮瓣均存活，仅发生2例血肿和1例无菌性瘘管。根据我们的结果，腓肠神经岛状筋膜皮瓣是一种有感觉的重建选择，可为覆盖膝关节周围的皮肤缺损提供优质且可靠的软组织。
