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同步比目鱼肌和逆行腓肠神经营养血管皮瓣修复小腿大面积软组织缺损

Synchronous Soleus and Reverse Sural Flap for Large Soft Tissue Defect Reconstruction of Leg.

作者信息

Hassanpour Seyed Esmail, Yavari Masoud, Motabar Amir Reza

机构信息

Department of Plastic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

World J Plast Surg. 2018 Jan;7(1):12-15.

Abstract

BACKGROUND

Extended Soft tissue defect of leg including middle and distal parts always has been a challenge for many plastic surgeons and also a frustrated problem for patients and families. To introduce the use of the soleus muscle and reverse sural flaps as synchronous surgical treatment alternative of the leg bone exposure with large soft tissue defect, this study was conducted.

METHODS

The medical records of patients undergoing transposition of the soleus muscle for treating exposed bone in the leg and simultaneous sural flap were retrospectively analyzed from January 2009 to July 2014, while gathering information on the used muscle was to cover the lesion.

RESULTS

Twelve patients with varying ages between 22 and 58 years (10 males and 2 females) were enrolled. The main initial injury was trauma (84.8%), consisting of tibia and/or fibula fractures. Only 1 patient developed insignificant distal flap necrosis who was treated subsequently with surgical debridement and flap re-advancement.

CONCLUSION

The treatment of bone exposure with local muscle flaps (soleus and sural) enables obtaining satisfactory results in covering of exposed structures, favoring local vascularization and improving the initial injury. It offers the advantage of providing a treatment in only one surgical procedure, an earlier recovery and reduced hospital stay. Sometimes, this method may be applied instead of free tissue transfer.

摘要

背景

小腿中下段广泛软组织缺损一直是众多整形外科医生面临的挑战,也是患者及其家属深感困扰的问题。为介绍比目鱼肌肌瓣和逆行腓肠神经营营皮瓣同步转移修复小腿骨外露并伴有大面积软组织缺损的方法,我们开展了本研究。

方法

回顾性分析2009年1月至2014年7月期间,采用比目鱼肌肌瓣转移修复小腿骨外露并同期行腓肠神经营营皮瓣转移修复的患者病历资料,收集关于所用肌瓣覆盖创面的相关信息。

结果

纳入12例患者,年龄22至58岁不等(男性10例,女性2例)。主要初始损伤为创伤(84.8%),包括胫腓骨骨折。仅1例患者出现轻微的皮瓣远端坏死,随后经手术清创及皮瓣再次推进处理。

结论

采用局部肌瓣(比目鱼肌和腓肠肌)修复骨外露,在覆盖外露结构、促进局部血运及改善初始损伤方面可获得满意效果。该方法具有仅通过一次手术即可完成治疗、恢复较早且住院时间缩短的优势。有时,此方法可替代游离组织移植。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1257/5890361/69f0faafe4fa/wjps-7-012-g001.jpg

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