Division of Plastic Surgery and the Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, Seattle, WA, USA.
J Am Acad Orthop Surg. 2011 Feb;19(2):81-90. doi: 10.5435/00124635-201102000-00003.
Soft-tissue loss associated with lower extremity fracture poses a substantial reconstructive challenge. Following stabilization of life-threatening conditions and bony disruptions, the reconstructive team must address the soft-tissue envelope of the limb. The wound is managed with débridement followed by coverage. Coverage options range from basic to complex and include delayed primary closure, healing by secondary intention, skin grafting, local flap coverage, and distant tissue transfer. The choice of soft-tissue coverage method is based on its ability to provide an environment conducive to fracture healing. Understanding the merits and disadvantages of each reconstructive option helps to avoid undertreatment or overtreatment.
下肢骨折伴发的软组织缺失给重建带来了巨大挑战。在危及生命的状况和骨组织破坏得到稳定后，重建团队必须处理肢体的软组织覆盖。伤口通过清创后进行覆盖处理。覆盖的选择范围从基本到复杂，包括延期一期缝合、二期愈合、植皮、局部皮瓣覆盖和远处组织转移。软组织覆盖方法的选择基于其为骨折愈合提供有利环境的能力。了解每种重建选择的优缺点有助于避免治疗不足或过度治疗。
