Lukash F N
Ann Plast Surg. 1985 Sep;15(3):252-6. doi: 10.1097/00000637-198509000-00010.
Large plantar defects present a difficult problem in reconstructive surgery. Skin grafts are not durable and most distant flaps are too bulky to allow for ambulation in conventional footwear. Free muscle transfer with skin graft may represent a modality to provide a contoured and durable reconstruction for large plantar defects when local tissue is not available. This study presents a case of sole of foot and distal heel reconstruction with a free microvascular latissimus muscle transfer. The transfer was contoured to fit the defect and then covered with a split-thickness skin graft. Three months following surgery, the patient was walking without assistive devices and using conventional footwear. Now, two and one-half years after surgery, he is employed full-time in a job that entails walking, and has never experienced a tissue breakdown.
大面积足底缺损在重建手术中是个难题。皮肤移植不耐用，大多数远位皮瓣过于臃肿，无法穿着传统鞋具行走。当无法利用局部组织时，带皮肤移植的游离肌肉移植可能是为大面积足底缺损提供外形良好且持久重建的一种方式。本研究报告了1例采用游离微血管背阔肌移植进行足底和足跟远端重建的病例。将移植的肌肉塑形以适应缺损，然后覆盖中厚皮片。术后3个月，患者无需辅助装置即可行走，并能穿着传统鞋具。现在，术后两年半，他全职从事一份需要行走的工作，且从未出现组织破溃情况。
