Koizumi Takuya, Nakagawa Masahiro, Nagamatsu Shogo, Kayano Shuji, Akazawa Satoshi, Katsuragi Yoko, Matsui Takahiro, Yamamoto Yusuke
Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
J Plast Surg Hand Surg. 2013 Sep;47(4):276-80. doi: 10.3109/2000656X.2012.759955. Epub 2013 May 28.
Reconstruction using flaps with good blood circulation is appropriate for covering an intractable ulcer or a fistula in which tendon or bones are exposed. A non-vascularised perifascial areolar tissue (PAT) graft can also survive in such an area. This study reports the versatile application of a PAT graft for use as a non-vascularised graft material. A total of 32 patients were treated between April 2004 and December 2010 (16 men and 16 women). The donor sites were the inguinal region in 20, the thigh in 11, and the subclavian region in one. There were 13 inlay grafts to the dead space after tumour resection, eight closures for cerebrospinal fluid leakage, seven skin ulcers with exposed bones and tendons, three fistulas, and one vascular leak of the common carotid artery. The total survival rate of the grafts was 91%. The complications associated with this procedure included infection in 9% and seroma in the donor site in 19%. However, all cases improved after conservative treatment. The PAT is a pliable loose areolar tissue with a rich vascular plexus, and the harvesting technique is quite simple and minimally invasive. The PAT graft could therefore represent an alternative for flaps that are used as a free graft material for the reconstruction of such defects as intractable skin ulcers, fistulas or dead spaces that usually require reconstruction with vascularised flaps.
使用血运良好的皮瓣进行重建适用于覆盖肌腱或骨骼外露的顽固性溃疡或瘘管。无血管化的筋膜周蜂窝组织（PAT）移植物也能在该区域存活。本研究报告了PAT移植物作为无血管化移植物材料的多种应用。2004年4月至2010年12月期间共治疗了32例患者（男性16例，女性16例）。供区位于腹股沟区20例，大腿11例，锁骨下区1例。肿瘤切除后有13例镶嵌移植物用于填充死腔，8例用于闭合脑脊液漏，7例用于治疗骨骼和肌腱外露的皮肤溃疡，3例用于治疗瘘管，1例用于治疗颈总动脉血管渗漏。移植物的总存活率为91%。该手术相关的并发症包括9%的感染和19%的供区血清肿。然而，所有病例经保守治疗后均有改善。PAT是一种柔韧的疏松蜂窝组织，有丰富的血管丛，采集技术非常简单且微创。因此，PAT移植物可作为皮瓣的替代物，用作游离移植物材料，用于重建通常需要带血管皮瓣重建的顽固性皮肤溃疡、瘘管或死腔等缺损。
