Sadove R C, Vasconez H C, Arthur K R, Draud J W, Burgess R C
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084.
Plast Reconstr Surg. 1991 Jul;88(1):115-20. doi: 10.1097/00006534-199107000-00020.
This paper reports the authors' experience with latissimus dorsi island pedicle flaps in the acute treatment of massive arm injuries. Seven patients with upper arm injuries and four patients with forearm injuries were treated with latissimus dorsi pedicle flaps. All cases involved massive soft-tissue loss and open fractures. Primary healing of wounds occurred without complications in 10 of 11 patients; the eleventh developed a wound infection. There were no instances of flap loss or vascular complications. This report compares and discusses surgical management options and details the importance of robust, immediate soft-tissue coverage for optimal functional recovery. Contrary to traditional thought, delay in definitive wound closure may be unnecessary when aggressive debridement is followed by acute flap closure.
本文报告了作者使用背阔肌岛状蒂皮瓣急性治疗严重手臂损伤的经验。7例上臂损伤患者和4例前臂损伤患者接受了背阔肌蒂皮瓣治疗。所有病例均伴有大面积软组织缺损和开放性骨折。11例患者中有10例伤口一期愈合且无并发症；第11例发生了伤口感染。没有皮瓣坏死或血管并发症的情况。本报告比较并讨论了手术治疗方案，并详细阐述了为实现最佳功能恢复而进行可靠、即时软组织覆盖的重要性。与传统观念相反，在积极清创后立即进行皮瓣闭合时，可能无需延迟进行确定性伤口闭合。
