AP-HP, Pitié-Salpêtrière University Hospital, University of Paris 6-Pierre et Marie Curie, Department of Maxillo-facial Surgery, Paris, France.
J Craniomaxillofac Surg. 2011 Apr;39(3):206-8. doi: 10.1016/j.jcms.2010.03.012. Epub 2010 May 14.
Donor site morbidity for free fibula osteofasciocutaneous flaps has rarely been reported in the literature. We report on a case of acute compartment syndrome (ACS) in a 22-year-old male, following fibula flap harvest for mandibular reconstruction and arising after post-ischemic reperfusion damage. Dissection during this patient's surgery was unusually difficult. The skin defect was covered with a loose dressing while waiting for secondary grafting. Intracompartmental pressures measured by the Wick catheter technique confirmed the diagnosis of ACS. ACS is an unexpected complication after fibula flap harvest since the three compartments of the leg are opened during surgery. Only four cases of ACS have been reported in the literature. Analysis of this serious complication might lead to changes in the routine use of the pneumatic tourniquet in some selected cases. New automatic tourniquet systems might also be advantageous in such cases.
游离腓骨肌皮瓣供区的发病率在文献中鲜有报道。我们报告了一例 22 岁男性患者，在行游离腓骨瓣下颌骨重建术后发生急性骨筋膜室综合征（ACS），其发病机制为缺血再灌注损伤。该患者的手术解剖非常困难。皮瓣供区缺损处先用松质敷料覆盖，等待二期植皮。采用 Wick 导管技术测量的骨间室内压力证实了 ACS 的诊断。腓骨皮瓣游离后发生 ACS 是一种意外并发症，因为手术中会打开小腿的三个骨筋膜室。文献中仅报道了 4 例 ACS。对这种严重并发症的分析可能会导致在某些特定情况下改变使用气压止血带的常规。在这种情况下，新型自动止血带系统可能也具有优势。
