Division of Plastic and Reconstructive Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, USA.
J Reconstr Microsurg. 2012 Oct;28(8):521-8. doi: 10.1055/s-0032-1315772. Epub 2012 Jun 18.
Management of complicated open wounds of the extremities represents a reconstructive challenge. The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissues for optimal restoration of its form and function. We present our experience with the use of scapular fascial free flaps in the reconstruction of complicated open wounds of the extremities. During the period 2001 to 2009, a total of 12 reconstructions utilizing scapular fascial free flaps were performed: nine for upper extremity wounds and three for lower extremity wounds. Two flaps failed: in one case due to intractable vasospasm, in the other case due to lack of adequate recipient vessels. In the ten successful cases, good functional and aesthetic outcomes were achieved. Based on our experience, we conclude that the scapular fascial free flap, although technically demanding, could be considered as the flap of choice for reconstruction of complicated open wounds of the extremities; it provides ample thin and well vascularized soft tissue coverage with restoration of function and a natural contour of the extremity.
四肢复杂性开放伤口的处理是一项重建挑战。重建的目标是用血运良好的组织覆盖暴露的重要结构，以最佳地恢复其形态和功能。我们介绍了我们在四肢复杂性开放伤口重建中使用肩胛筋膜游离皮瓣的经验。在 2001 年至 2009 年期间，共进行了 12 例使用肩胛筋膜游离皮瓣的重建：9 例用于上肢伤口，3 例用于下肢伤口。有 2 个皮瓣失败：一个是由于难以治疗的血管痉挛，另一个是由于缺乏足够的受区血管。在 10 例成功的病例中，取得了良好的功能和美学效果。根据我们的经验，我们得出结论，肩胛筋膜游离皮瓣虽然技术要求较高，但可被视为重建四肢复杂性开放伤口的首选皮瓣；它提供了充足的薄而血运良好的软组织覆盖，恢复了功能和肢体的自然轮廓。
