Department of Plastic and Reconstructive Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea.
Diabetes Metab Res Rev. 2016 Jan;32 Suppl 1:275-80. doi: 10.1002/dmrr.2755.
The treatment of diabetic foot ulceration is complex with multiple factors involved, and it may often lead to limb amputation. Hence, a multidisciplinary approach is warranted to cover the spectrum of treatment for diabetic foot, but in complex wounds, surgical treatment is inevitable. Surgery may involve the decision to preserve the limb by reconstruction or to amputate it. Reconstruction involves preserving the limb with secure coverage. Local flaps usually are able to provide sufficient coverage for small or moderate sized wound, but for larger wounds, soft tissue coverage involves flaps that are distantly located from the wound. Reconstruction of distant flap usually involves microsurgery, and now, further innovative methods such as supermicrosurgery have further given complex wounds a better chance to be reconstructed and limbs salvaged. This article reviews the microsurgery involved in reconstruction and introduces the new method of supermicrosurgery.
糖尿病足溃疡的治疗很复杂，涉及多个因素，并且可能经常导致截肢。因此，需要多学科方法来涵盖糖尿病足的治疗范围，但在复杂的伤口中，手术治疗是不可避免的。手术可能涉及通过重建来保留肢体或截肢的决定。重建涉及通过安全覆盖来保留肢体。局部皮瓣通常能够为小或中等大小的伤口提供足够的覆盖，但对于较大的伤口，软组织覆盖需要从伤口远处转移皮瓣。远处皮瓣的重建通常涉及显微外科手术，现在，进一步的创新方法，如超级显微外科手术，为复杂伤口的重建和肢体挽救提供了更好的机会。本文综述了重建中涉及的显微外科手术，并介绍了超级显微外科手术的新方法。
