Hafeez Kamran, Abbas Kashif
Dow International Medical College, Dow University of Health Sciences, Karachi.
Islam Medical College, Sialkot, Pakistan.
J Pak Med Assoc. 2014 Dec;64(12 Suppl 2):S15-8.
To assess the results of cases with complex wounds exposing tibia who were managed with distally based random flaps.
The retrospective study was conducted at Aga Khan University Hospital, Karachi, and Dow University Hospital, Karachi and comprised data between February 2000 and March 2013of patients who had been admitted with a recent or prior history of trauma with a soft tissue defect in upper two-thirds of tibia and who had undergone coverage procedure using distal based flap.
The mean age of the total 21 patients in the study was 29±9 years, and 20(95%)were male. Road traffic accident was the most common mechanism of injury in 13(62%). Tibia was exposed in all the 21(100%) cases requiring soft tissue coverage. There was associated fracture of tibia in 18(86%) patients. Mean flap length was 12±1.7 cm and width was 5.3 ±0.86 cm. Maximum size for the flap dissected was 15x7cm. Donor site was covered with split thickness skin graft in 19(90.5%) patients. Flap survival rate was 100%. Only 2(9.5%) patients developed partial flap necrosis. Clinical outcome was graded as good in 19(90.5%) patients and fair in 2(9.5%). Superficial infection was observed in 2(9.5%) patients.
Distal based flap appeared to be an effective solution for the coverage of soft tissue defects in upper two-thirds of leg.
评估采用远端随意皮瓣治疗胫骨外露复杂伤口病例的效果。
本回顾性研究在卡拉奇的阿迦汗大学医院和卡拉奇的道氏大学医院开展，纳入了2000年2月至2013年3月期间因近期或既往有创伤史且胫骨上三分之二存在软组织缺损而入院，并接受了远端皮瓣覆盖手术的患者数据。
本研究中21例患者的平均年龄为29±9岁，其中20例（95%）为男性。道路交通事故是最常见的致伤原因，共13例（62%）。21例（100%）需要软组织覆盖的病例均有胫骨外露。18例（86%）患者合并胫骨骨折。皮瓣平均长度为12±1.7 cm，宽度为5.3±0.86 cm。切取的最大皮瓣尺寸为15×7 cm。19例（90.5%）患者的供区采用了中厚皮片覆盖。皮瓣存活率为100%。仅2例（9.5%）患者出现部分皮瓣坏死。19例（90.5%）患者的临床结局评定为良好，2例（9.5%）为一般。2例（9.5%）患者出现浅表感染。
远端皮瓣似乎是覆盖小腿上三分之二软组织缺损的有效方法。
