全膝关节置换翻修术的软组织重建与皮瓣覆盖
Soft Tissue Reconstruction and Flap Coverage for Revision Total Knee Arthroplasty.
作者信息
Rao Allison J, Kempton Steven J, Erickson Brandon J, Levine Brett R, Rao Venkat K
机构信息
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
Division of Plastic Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
出版信息
J Arthroplasty. 2016 Jul;31(7):1529-38. doi: 10.1016/j.arth.2015.12.054. Epub 2016 Mar 31.
BACKGROUND
Total knee arthroplasty is a successful operation for treatment of arthritis. However, devastating wound complications and infections can compromise the knee joint, particularly in revision situations.
METHODS
Soft tissue loss associated with poor wound healing and multiple operations can necessitate the need for reconstruction for wound closure and protection of the prosthesis.
RESULTS
Coverage options range from simple closure methods to complex reconstruction, including delayed primary closure, healing by secondary intention, vacuum-assisted closure, skin grafting, local flap coverage, and distant microsurgical tissue transfer.
CONCLUSION
Understanding the advantages and pitfalls of each reconstructive option helps to guide treatment and avoid repeated operations and potentially devastating consequences such as knee arthrodesis or amputation.
背景
全膝关节置换术是治疗关节炎的一种成功手术。然而，严重的伤口并发症和感染会影响膝关节，尤其是在翻修情况下。
方法
与伤口愈合不良和多次手术相关的软组织缺损可能需要进行重建以闭合伤口并保护假体。
结果
覆盖选择范围从简单的闭合方法到复杂的重建，包括延迟一期闭合、二期愈合、负压封闭引流、植皮、局部皮瓣覆盖和远处显微外科组织转移。
结论
了解每种重建选择的优缺点有助于指导治疗，避免重复手术以及诸如膝关节融合或截肢等潜在的严重后果。
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