Osman Soleiman, Chou Stephanie, Rosing James, Sahar David E
Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California Davis Medical Center, Sacramento, Calif.
Eplasty. 2013 Sep 27;13:e50. eCollection 2013.
Soft tissue coverage of the exposed Achilles tendon is a unique reconstructive challenge. In this report, we describe the management of a large posterior leg wound with exposed Achilles tendon using a free anterolateral thigh (ALT) flap. A careful review of alternative reconstructive options is included, along with their respective advantages and disadvantages. A 32-year-old white man suffered a fulminant right lower extremity soft tissue infection requiring extensive debridement of the entire posterior surface of the right leg. The resulting large soft tissue defect included exposure of the Achilles tendon. Reconstruction of the defect was achieved with an ALT flap and split-thickness skin graft for coverage of the Achilles tendon and gastrocnemius muscle, respectively. The patient was able to ambulate independently within 2 months of the procedure.
暴露的跟腱的软组织覆盖是一项独特的重建挑战。在本报告中，我们描述了使用游离股前外侧（ALT）皮瓣处理伴有跟腱暴露的大腿后部大伤口的情况。文中仔细回顾了其他重建选择方案及其各自的优缺点。一名32岁白人男性发生了暴发性右下肢软组织感染，需要对右腿整个后表面进行广泛清创。由此产生的大软组织缺损包括跟腱暴露。通过ALT皮瓣和分别用于覆盖跟腱和腓肠肌的中厚皮片移植实现了缺损的重建。患者在手术后2个月内能够独立行走。
