Alnaif Nayif, Lee James, Azzi Alain Joe, Aldekhayel Salah, Zadeh Teanoosh
Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, QC, Canada.
SAGE Open Med Case Rep. 2019 Jan 22;7:2050313X18823438. doi: 10.1177/2050313X18823438. eCollection 2019.
The management of a mangled limb is a challenging endeavor. With the advancement in microsurgery, spare parts surgery (fillet flaps) has gained recent interest. In the context of lower extremity amputation secondary to trauma, viable spare parts can provide stump soft tissue coverage, potentially preserving critical length and obviating above-knee amputations. Commonly, spare parts surgery is performed in the acute setting but tissue preservation is sometimes necessary. The authors report their experience preserving a fillet flap of a mangled lower extremity for 48 h using the University of Wisconsin solution. A sole fillet flap and a split-thickness skin graft were harvested and preserved from the amputated lower extremity (based on the posterior tibial artery and vein). Stump coverage was achieved by anastomosing the fillet flap to the proximal posterior tibial artery and vein. This solution has not been previously described for preservation of fillet flaps.
严重毁损肢体的处理是一项具有挑战性的工作。随着显微外科技术的进步，备用组织移植手术（带蒂皮瓣）近来受到了关注。在创伤继发下肢截肢的情况下，可用的备用组织能够覆盖残端软组织，有可能保留关键长度并避免膝上截肢。通常，备用组织移植手术在急性期进行，但有时需要进行组织保存。作者报告了他们使用威斯康星大学溶液将严重毁损的下肢带蒂皮瓣保存48小时的经验。从截肢的下肢（基于胫后动静脉）获取并保存了一块单独的带蒂皮瓣和一块中厚皮片。通过将带蒂皮瓣与近端胫后动静脉吻合来实现残端覆盖。此前尚未有关于使用该溶液保存带蒂皮瓣的描述。
