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尼日利亚拉各斯微血管游离组织移植的早期经验。

Early experiences with microvascular free tissue transfer in lagos, Nigeria.

作者信息

Mofikoya Bolaji O, Ugburo Andrew O

机构信息

Department of Surgery, Burns, Plastic, Hand Rehabilitation Unit, College of Medicine University of Lagos/Lagos University Teaching Hospital, Idiaraba, Lagos, Nigeria.

出版信息

Niger J Surg. 2014 Jan;20(1):35-7. doi: 10.4103/1117-6806.127108.

Abstract

OBJECTIVES

Microvascular free tissue transfer within our subregion is fraught with considerable challenges. We aim to highlight our experiences gained with our first fifteen cases of microvascular free tissue transfer at the Lagos University Teaching Hospital. We believe our report will be useful to colleagues embarking on such reconstructions in similar settings.

MATERIALS AND METHODS

The clinical records of the first 15 cases of free flaps done at our center were reviewed. The indications for surgery, choice of flap, recipient vessels, duration of surgery and complications were noted.

RESULTS

Fifteen cases were done, 10 flaps survived, ten defects occurred following trauma while remaining five followed cancer resections. Anterolateral thigh and radial forearm flaps were the most common flap used. The mean duration of surgeries was 7.1 hours SD ± 1.10 hours. Our take back rate was 13.3%, with a salvage rate of 50%. Three flaps failed on account venous congestion while remaining two failed due to arterial occlusion.

CONCLUSION

66.67% free flap success rate recorded reflect our early experiences in our institution. We believe meticulous planning, careful vessel selection, close flap monitoring as well as improved infrastructural support can lead to much better success rates in microvascular reconstruction in our country.

摘要

目的

在我们所在的次区域进行微血管游离组织移植充满了巨大挑战。我们旨在突出在拉各斯大学教学医院进行的前15例微血管游离组织移植所获得的经验。我们相信我们的报告将对在类似环境中开展此类重建手术的同行有所帮助。

材料与方法

回顾了我们中心完成的前15例游离皮瓣手术的临床记录。记录手术指征、皮瓣选择、受区血管、手术时长及并发症情况。

结果

共完成15例手术,10例皮瓣存活,10例缺损由创伤引起,其余5例由癌症切除引起。股前外侧皮瓣和桡动脉前臂皮瓣是最常用的皮瓣。手术平均时长为7.1小时,标准差±1.10小时。我们的回植率为13.3%,挽救率为50%。3例皮瓣因静脉淤血失败,另外2例因动脉阻塞失败。

结论

所记录的66.67%的游离皮瓣成功率反映了我们机构的早期经验。我们相信精心规划、仔细选择血管、密切监测皮瓣以及改善基础设施支持能够在我国微血管重建中取得更高的成功率。

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