Frame J D, Taweepoke P, Moieman N, Rylah L
St Andrew's Hospital, Billericay, Essex, UK.
Burns. 1990 Oct;16(5):381-4. doi: 10.1016/0305-4179(90)90013-m.
There is a small percentage of burned patients who would benefit from early excision of burns and coverage of exposed large joints to prevent septic arthritis and preserve movement. There are many reports in the literature on flap coverage of exposed joints or delayed primary excision of burns with subsequent flap coverage, but the immediate excision of burn to fascia with use of local vascularized fascial flaps to cover open knee and ankle joints has not apparently been described. This case report illustrates the basic plastic surgery techniques involved and the rationale behind such aggressive management. Biobrane is an extremely useful dressing for the coverage of such wounds in the interim period before autografting and provides ideal temporary coverage of vascularized fascial flaps and the excised burn bed.
有一小部分烧伤患者会从早期烧伤切除和覆盖暴露的大关节中受益，以预防化脓性关节炎并保留关节活动度。文献中有许多关于暴露关节的皮瓣覆盖或烧伤延迟一期切除并随后进行皮瓣覆盖的报道，但使用局部带血管筋膜皮瓣立即将烧伤切除至深筋膜以覆盖开放的膝关节和踝关节的情况显然尚未见描述。本病例报告阐述了所涉及的基本整形外科技术以及这种积极治疗背后的原理。生物敷料是自体移植前这段时间覆盖此类伤口的极为有用的敷料，可为带血管筋膜皮瓣和切除的烧伤创面提供理想的临时覆盖。
