Boernert Katja, Ganot Gili, Ulrich Martin Keith, Iselin Lukas Daniel
Luzerner Kantonsspital Zentrumsspital, Orthopaedic Surgery and Traumatology, Luzern, LU CH 6000, Switzerland.
Assaf Harofeh Medical Center, Orthopaedic Surgery and Traumatology, Tel Aviv, Israel.
Trauma Case Rep. 2018 Apr 23;15:8-15. doi: 10.1016/j.tcr.2018.04.003. eCollection 2018 Jun.
Severe injuries of the foot are a life-changing event. They often lead to some form of disability, and are therefore very challenging to manage. Injuries of the extremity, especially the foot and ankle, are distinct predictors of poor outcome in polytrauma patients.Degloving injuries of the lower extremity involving the heel and foot are a rare and unique subgroup of severe foot injuries.Treating degloving injuries is challenging. The surgical approach has to take into consideration both osseous and massive soft tissue injuries aiming to preserve the unique architecture of the lower limb and reconstruct the soft tissue.There are several surgical approaches for treating degloving injuries of the lower limb.
We would like to share our experience with two cases of young very active patients who suffered from a complex injury of the lower limb that included a massive degloving injury. It was of paramount importance to salvage the lower limb and keep it functional.Both patients were treated while using the degloved skin as a defatted full thickness skin flap that was replanted on the injured limb followed by application of VAC-therapy.
We treated two patients suffering a severe degloving injury of the lower extremity with degloved skin as a full thickness flap in order to preserve both the extremity itself as well as the function of the lower limb according to the individual requirements of the patients. Consequently, we could enable the patient to pursue their professional musical training requiring subtle use of the lower extremity as well as ensuring sufficient function of the lower extremity in everyday use.
足部严重损伤是改变人生的事件。它们常常导致某种形式的残疾，因此治疗极具挑战性。肢体损伤，尤其是足踝部损伤，是多发伤患者预后不良的明显预测因素。累及足跟和足部的下肢脱套伤是严重足部损伤中罕见且独特的亚组。治疗脱套伤具有挑战性。手术方法必须兼顾骨组织和大面积软组织损伤，旨在保留下肢独特的结构并重建软组织。治疗下肢脱套伤有多种手术方法。
我们想分享两例年轻且活动能力很强的患者的治疗经验，他们遭受了包括大面积脱套伤在内的下肢复杂损伤。挽救下肢并使其保持功能至关重要。两名患者在治疗时均将脱套皮肤用作去脂全厚皮瓣，重新移植到受伤肢体上，随后进行负压封闭引流治疗。
我们将两名下肢严重脱套伤患者的脱套皮肤作为全厚皮瓣进行治疗，以便根据患者的个体需求保留肢体本身以及下肢功能。因此，我们能够使患者继续他们需要精细使用下肢的专业音乐训练，同时确保下肢在日常使用中有足够的功能。
