Gorman P W, Barnes C L, Fischer T J, McAndrew M P, Moore M M
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Clin Orthop Relat Res. 1989 Jun(243):57-64.
The reconstruction of soft tissues is a difficult aspect of limb salvage after severe lower extremity injury. Newer techniques such as free-tissue transfer can expedite wound care, decrease morbidity and hospital costs, and spare some limbs from amputation. It is important to know the mechanism of injury and the resultant zone of soft-tissue trauma. This is best defined by serial debridements over several days. The final defect size and composition will determine the type of soft-tissue flap used. Soft-tissue coverage may be accomplished with muscle, with muscle and skin transposition, or with free transfer. Microvascular transfers offer the advantage of one procedure that provides coverage for donor and recipient sites with early patient mobilization.
软组织重建是严重下肢损伤后肢体挽救的一个难题。诸如游离组织移植等新技术可以加快伤口护理，降低发病率和住院费用，并使一些肢体免于截肢。了解损伤机制和由此产生的软组织创伤区域很重要。这最好通过在几天内进行连续清创来确定。最终的缺损大小和构成将决定所使用的软组织瓣的类型。软组织覆盖可以通过肌肉、肌肉和皮肤移位或游离移植来完成。微血管移植的优点是一次手术就能为供区和受区提供覆盖，同时能使患者早期活动。
