Heidekrueger Paul I, Mueller Camillo, Thiha Aung, Ehrl Denis, Weinschenk Fabian, Herter Frank, Ninkovic Milomir, Prantl Lukas
a Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery , University of Regensburg , Regensburg , Germany.
b Department for Plastic and Hand Surgery , CHUV Centre de la Main , Lausanne , Switzerland.
J Plast Surg Hand Surg. 2018 Dec;52(6):347-351. doi: 10.1080/2000656X.2018.1498792. Epub 2018 Sep 4.
Wound healing problems following acute and chronic olecranon bursitis can result in problematic tissue defects around the elbow. These defects often require a regional flap or a free flap for durable tissue coverage. The aim of this study was to assess clinical outcome the lateral arm flap (LAF) used to cover tissue defects caused by chronic olecranon bursitis. Between 2011 and 2015, 13 patients with soft tissue defects of the elbow resulting from chronic bursitis olecrani were treated in an interdisciplinary approach. First sufficient debridement was performed in conjunction with the orthopedic surgeons. Then, using a defect specific algorithm, reconstruction followed using pedicled extended LAFs or reverse LAFs, with and without inclusion of triceps muscle tissue. Mean follow-up was 52.3 months (range 23-72 months). There were no complete flap losses. All flaps healed in nicely without major wound healing complications. No patient showed signs of recurrent infections during follow-up, and all patients were able to achieve full range of motion post-operatively. Depending on the size of the defect, the conditions of the surrounding tissues, involvement of the elbow joint or need for sensate tissue, reconstruction may require different approaches. In our opinion the LAF can be designed to address these demands.
急性和慢性鹰嘴滑囊炎后的伤口愈合问题可导致肘部周围出现有问题的组织缺损。这些缺损通常需要局部皮瓣或游离皮瓣来实现持久的组织覆盖。本研究的目的是评估用于覆盖慢性鹰嘴滑囊炎所致组织缺损的上臂外侧皮瓣(LAF)的临床效果。2011年至2015年期间,对13例因慢性鹰嘴滑囊炎导致肘部软组织缺损的患者采用多学科方法进行治疗。首先,与骨科医生一起进行充分的清创。然后,使用特定缺损算法,采用带蒂延长型LAF或逆行LAF进行重建,包括或不包括肱三头肌组织。平均随访时间为52.3个月(范围23 - 72个月)。没有皮瓣完全坏死的情况。所有皮瓣愈合良好,无重大伤口愈合并发症。随访期间没有患者出现反复感染的迹象,所有患者术后均能实现全关节活动度。根据缺损大小、周围组织情况、肘关节受累情况或对感觉组织的需求,重建可能需要不同的方法。我们认为LAF可以设计满足这些需求。