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循证医学:急性下肢创伤的管理

Evidence-Based Medicine: Management of Acute Lower Extremity Trauma.

作者信息

Lachica Roberto D

机构信息

Memphis, Tenn.

From the Department of Plastic Surgery, UT Medical Group, Inc.

出版信息

Plast Reconstr Surg. 2017 Jan;139(1):287e-301e. doi: 10.1097/PRS.0000000000002860.

Abstract

LEARNING OBJECTIVES

After studying this article, the participant should be able to: 1. Select and design flaps for the acutely injured lower limb based on wound location, size, and complexity. 2. Select and design tissue-specific flaps based on the functional demand of the zone of injury. 3. Understand the indications for using a flap with a skin component versus a muscle-only flap. 4. Understand the preoperative vascular assessment for lower extremity flap reconstruction. 5. Recognize and manage risk factors to decrease complications and improve flap survival.

SUMMARY

The Maintenance of Certification series is designed to help the experienced surgeon structure the study of specific areas appropriate to his or her clinical practice. This article is designed to accompany practice-based evaluation of preoperative assessment, surgical treatment plan, and outcomes. In this format, he or she is invited to compare his or her methods with authoritative, information-based references. This information base is then used for self-assessment and benchmarking in Parts II and IV of the Maintenance of Certification process used by the American Board of Plastic Surgery. This article is not meant to be an exhaustive treatise on the subject, but rather designed to serve as a reference point for further in-depth study by review of the articles referenced. The goal of this article is to present evidence that may serve as practice-changing information. Furthermore, this article is designed with the recognition that participants may have different backgrounds, experience, expertise, and resources. The breadth of the topics discussed is designed to accommodate these differences.

摘要

学习目标

在研读本文后,参与者应能够:1. 根据伤口位置、大小和复杂程度,选择并设计用于急性损伤下肢的皮瓣。2. 根据损伤区域的功能需求,选择并设计特定组织的皮瓣。3. 理解使用带皮肤成分的皮瓣与仅使用肌肉皮瓣的适应证。4. 理解下肢皮瓣重建的术前血管评估。5. 识别并处理风险因素以减少并发症并提高皮瓣存活率。

总结

继续医学教育认证系列旨在帮助经验丰富的外科医生构建与其临床实践相关的特定领域的学习。本文旨在配合基于实践的术前评估、手术治疗计划及结果的评估。以这种形式,邀请外科医生将自己的方法与权威的、基于信息的参考文献进行比较。然后,该信息库用于美国整形外科委员会继续医学教育认证过程第二部分和第四部分的自我评估及基准测试。本文并非该主题的详尽论述,而是旨在作为通过查阅参考文献进行进一步深入研究的参考点。本文的目标是呈现可能作为改变实践信息的证据。此外,本文的设计考虑到参与者可能有不同的背景、经验、专业知识和资源。所讨论主题的广度旨在适应这些差异。

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