Khundkar Roba
Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, UK.
J Clin Orthop Trauma. 2019 Sep-Oct;10(5):839-844. doi: 10.1016/j.jcot.2019.08.007. Epub 2019 Aug 11.
Lower extremity injuries requiring soft tissue coverage comprises a significant proportion of these injuries worldwide. Reconstruction of the soft tissues overlying fractures is essential for bone union and reduction of infection thus improving function and reducing the rate of limb amputation. A systematic exploration and excision of the wound should be jointly performed by senior surgeons from Orthopaedic and Plastic Surgery. The grading of the injury and subsequent reconstruction of bone and soft tissue should only be planned once a thorough excision of all necrotic tissue has been performed. It is this thorough debridement and early flap coverage that contributes to infection-free bony union. This article explores the options for soft tissue flap coverage for the different zones in the lower limb.
在全球范围内,需要软组织覆盖的下肢损伤占这些损伤的很大比例。覆盖骨折部位的软组织重建对于骨愈合和减少感染至关重要,从而改善功能并降低肢体截肢率。骨科和整形外科的资深外科医生应联合对伤口进行系统探查和切除。只有在彻底切除所有坏死组织后,才能对损伤进行分级并随后规划骨和软组织的重建。正是这种彻底的清创和早期皮瓣覆盖有助于实现无感染的骨愈合。本文探讨了下肢不同区域软组织皮瓣覆盖的选择。