Tsai T M, Bennett D L, Pederson W C, Matiko J
Christine M. Kleinert Institute for Hand and Micro Surgery, University of Louisville School of Medicine, Ky.
Plast Reconstr Surg. 1988 Dec;82(6):1022-6. doi: 10.1097/00006534-198812000-00013.
Complications were examined in 122 free flaps to lower and upper extremities in 104 patients, and vascular salvage was examined in 182 free flaps to lower and upper extremities in 158 patients. All patients were treated by the same surgeon. The overall survival rate of flaps was 96 percent. Complications occurred in 22 percent of the flaps. Complication rates were lower in patients with one free flap than in patients with two. Flaps had more vascular complications than nonvascular. Accompanying skin islands were found to be necessary to monitor vascularized bone transfers in order to avoid flap failure. Flow in the pedicle was reestablished in all flaps, but a higher percentage of flaps with longer ischemic times were lost. Although vascular compromise occurred frequently (15 percent), prompt surgical exploration and reexploration were thought to have greatly increased free-flap survival.
对104例患者的122个下肢和上肢游离皮瓣的并发症进行了检查，对158例患者的182个下肢和上肢游离皮瓣的血管挽救情况进行了检查。所有患者均由同一位外科医生治疗。皮瓣的总体存活率为96%。22%的皮瓣出现了并发症。接受一个游离皮瓣的患者的并发症发生率低于接受两个游离皮瓣的患者。皮瓣的血管并发症比非血管并发症更多。发现伴随的皮岛对于监测带血管蒂骨移植很有必要，以避免皮瓣失败。所有皮瓣的蒂部血流均得以重建，但缺血时间较长的皮瓣丢失比例更高。尽管血管受损情况频繁发生（15%），但及时的手术探查和再次探查被认为极大地提高了游离皮瓣的存活率。
