Hallock G G
Division of Plastic Surgery, Allentown Hospital, Pa.
Plast Reconstr Surg. 1990 Aug;86(2):304-11. doi: 10.1097/00006534-199008000-00018.
Significant open wounds of the distal third of the lower leg that require some form of vascularized flap have historically been covered with distant cross-leg flaps or more appropriately with microsurgical tissue transfers. The rediscovery of the "random" fasciocutaneous flap as a reliable single-stage option for proximal lower leg defects has been extended distally to allow an expedient alternative in lieu of these more complicated procedures. Over the past 7 years, 17 selected patients had closure of distal leg and ankle wounds with 19 local antegrade-oriented fasciocutaneous flaps. All eventually healed without serious sequelae, although 5 (26 percent) had minor complications, except for one case that could only be salvaged with a free-tissue transfer in order to prevent limb amputation. For small- or moderate-sized, uncontaminated injuries, this approach warrants consideration under appropriate circumstances as a simpler option that may permit satisfactory healing and avoids the known risks of microsurgical tissue transfers.
小腿远端三分之一处的明显开放性伤口，若需要某种形式的带血管蒂皮瓣覆盖，以往一直采用远处的交腿皮瓣，或者更合适的是采用显微外科组织移植。“随意型”筋膜皮瓣被重新发现可作为小腿近端缺损可靠的一期修复选择，并已扩展至远端，以便在这些更为复杂的手术之外提供一种便捷的替代方法。在过去7年中，17例选定患者采用19个局部顺行筋膜皮瓣闭合小腿远端和踝部伤口。所有伤口最终均愈合且无严重后遗症，尽管5例（26%）出现轻微并发症，但有1例除外，该例只能通过游离组织移植挽救，以防止截肢。对于中小面积、未受污染的损伤，在适当情况下，这种方法值得考虑，作为一种更简单的选择，可能实现满意的愈合，并避免显微外科组织移植的已知风险。
