Division of Dermatology, Department of Medicine, University of California at San Diego, San Diego, California; Sutter Medical Group of the Redwoods, Sutter Pacific Medical Foundation, Santa Rosa, California.
Dermatol Surg. 2013 Sep;39(9):1334-9. doi: 10.1111/dsu.12254. Epub 2013 Jun 21.
Repair of below-the-knee lower extremity defects after Mohs micrographic surgery (MMS) that are not amenable to primary closure can be challenging given the high propensity for complications. No criterion standard exists for management of these wounds, but secondary-intention healing, partial- and full-thickness skin grafts (FTSGs), and various flaps are possible options to manage these wounds. Few data exist on the efficacy of FTSG repairs for lower extremity wounds.
Assess the efficacy and complications rates of FTSG repairs for lower extremity wounds after MMS.
This was a retrospective review of 80 FTSG repairs performed after MMS. Data were derived from 45 cases at Beth Israel Deaconess Medical Center and 35 cases at University of California, San Diego (UCSD) Medical Center.
Seventy-two of 80 cases (90%) had full graft survival, six (7.5%) had partial failure, and two (2.5%) had complete failure. In the cases where grafts had failed, wounds healed by secondary intention without further complications. Other complications included infections in nine (11%) cases and hematoma formation in two (2.5%).
FTSG is a consistent and safe reconstructive option for the management of lower extremity wounds after MMS.
Mohs 显微外科手术后（MMS），下肢缺损无法进行一期闭合修复，由于并发症高发，处理起来极具挑战性。目前尚无此类伤口的标准处理方法，但二期愈合、部分和全厚皮片移植（FTSG）以及各种皮瓣可能是处理这些伤口的可行选择。关于 FTSG 修复下肢创面的疗效数据很少。
评估 MMS 后 FTSG 修复下肢创面的疗效和并发症发生率。
这是对 80 例 MMS 后行 FTSG 修复的回顾性研究。数据来自 Beth Israel Deaconess 医疗中心的 45 例病例和加利福尼亚大学圣地亚哥分校医疗中心的 35 例病例。
80 例中有 72 例（90%）的皮片完全存活，6 例（7.5%）部分失败，2 例（2.5%）完全失败。在皮片失败的病例中，伤口通过二期愈合而没有进一步的并发症。其他并发症包括 9 例（11%）感染和 2 例（2.5%）血肿形成。
FTSG 是 MMS 后下肢创面处理的一种可靠且安全的重建选择。
