Kneser U, Arkudas A, Beier J P, Dragu A, Stübinger A, Lang W, Horch R E
Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
Zentralbl Chir. 2013 Oct;138(5):536-42. doi: 10.1055/s-0032-1328035. Epub 2013 Mar 4.
Skin and soft-tissue defects at the ischaemic lower extremity represent a challenging condition. Major amputations can be prevented by optimised surgical therapy. The aim of any intervention is the revascularisation and defect reconstruction of the extremity.
This article aims to provide a structured overview on up-to-date therapeutic strategies and differentiated indications for certain surgical flaps in combination with bypass surgery for the treatment of chronic "vascular" wounds.
Optimised conservative wound therapy, skin grafts, pedicled or microsurgical free flaps in combination with vascular bypasses can be applied to salvage ischaemic extremities. These operations require an interdisciplinary cooperation between vascular surgeons and plastic surgeons.
These procedures should accordingly only be performed in specialised high-volume centres with significant vascular surgical and microsurgical expertise.
缺血性下肢的皮肤和软组织缺损是一种具有挑战性的病症。通过优化手术治疗可避免大截肢。任何干预的目的都是实现肢体的血管再通和缺损重建。
本文旨在对最新的治疗策略以及某些手术皮瓣结合旁路手术治疗慢性“血管性”伤口的不同适应证进行结构化概述。
优化的保守伤口治疗、皮肤移植、带蒂或显微外科游离皮瓣结合血管旁路手术可用于挽救缺血肢体。这些手术需要血管外科医生和整形外科医生之间的跨学科合作。
因此，这些手术应仅在具备丰富血管外科和显微外科专业知识的大型专科中心进行。
