Mihara Makoto, Hara Hisako, Kikuchi Kazuki
Department of Lymphatic and Reconstructive Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan.
Department of Plastic and Reconstructive Surgery, Nadogaya Hospital, Chiba, Japan.
SAGE Open Med Case Rep. 2017 Jun 2;5:2050313X17711631. doi: 10.1177/2050313X17711631. eCollection 2017.
In this report, we placed focus on the immunological function of lymph nodes and performed lymph node transfer via a free flap to a site of refractory infection.
Case 1 describes a 34-year-old male suffering from compound fractures with severe crush injuries and burns in the right ankle joint. A 20 × 15 cm skin defect was observed around the right malleolus medialis, along with denuded tendons with bacterial infection. After conservative treatment, we transferred a lymph-node-containing free superficial circumflex iliac artery perforator flap to the region, with minimum debridement. No recurrence of wound infection appeared. Case 2 describes a 73-year-old male patient suffering from extensive contused wound in the right crus. Despite conservative treatment, the tibia gradually became denuded with computed tomography and magnetic resonance imaging revealing degeneration of the tibial cortex. We performed a free superficial circumflex iliac artery perforator flap containing lymph nodes to the chronic infection area. The wound area healed successfully.
In conclusion, lymph node transfer has a potential of treatment infection sites.
在本报告中，我们重点关注淋巴结的免疫功能，并通过游离皮瓣将淋巴结转移至难治性感染部位。
病例1为一名34岁男性，右侧踝关节遭受复合骨折、严重挤压伤和烧伤。在内侧踝关节周围观察到一个20×15 cm的皮肤缺损，伴有肌腱外露和细菌感染。保守治疗后，我们将含淋巴结的游离旋髂浅动脉穿支皮瓣转移至该区域，清创最少。伤口感染未复发。病例2为一名73岁男性患者，右侧小腿有广泛的挫伤伤口。尽管进行了保守治疗，但胫骨逐渐外露，计算机断层扫描和磁共振成像显示胫骨皮质退变。我们将含淋巴结的游离旋髂浅动脉穿支皮瓣转移至慢性感染区域。伤口成功愈合。
总之，淋巴结转移有治疗感染部位的潜力。
