Lister G, Scheker L
University of Utah, Salt Lake City 84132.
J Hand Surg Am. 1988 Jan;13(1):22-8. doi: 10.1016/0363-5023(88)90193-1.
Thirty-one emergency free flaps were applied to the upper extremities of patients who ranged in age from 16 to 57 years. The size of the skin defects ranged from 13 to 540 square centimeters, with an average of 145 square centimeters. A variety of flaps were used, including 14 lateral arm, seven groin, five latissimus, three first web space of the foot, one scapular and one medial arm. In patients with small defects, the operative time ranged from 3 to 9 hours, with an average of 4 hours and 54 minutes. The hospital stay was never longer than 4 days. In patients with medium size defects, the operating time ranged from 3 to 18 hours, with an average of 7 hours and 45 minutes. The hospital stay averaged 7.4 days. In large defects in which extensive reconstruction was undertaken before flap application, the operative time ranged from 3 to 20 hours, with an average of 11 hours and 54 minutes. The average hospital stay was 11.8 days. Twenty-nine of the 31 flaps survived in their entirety (93.5%). In one of the successful flaps (3.2%), exploration was required after the patient left the operating room. Severe infection occurred in only one case, that being one of the two flap failures. Twenty-seven of the 31 patients returned to work, 18 of them to their original employment.
31例急诊游离皮瓣应用于年龄在16至57岁的患者上肢。皮肤缺损面积为13至540平方厘米，平均为145平方厘米。使用了多种皮瓣，包括14例臂外侧皮瓣、7例腹股沟皮瓣、5例背阔肌皮瓣、3例足第一跖蹼皮瓣、1例肩胛皮瓣和1例臂内侧皮瓣。小面积缺损患者的手术时间为3至9小时，平均为4小时54分钟。住院时间从未超过4天。中等面积缺损患者的手术时间为3至18小时，平均为7小时45分钟。平均住院时间为7.4天。大面积缺损且在应用皮瓣前进行广泛重建的患者，手术时间为3至20小时，平均为11小时54分钟。平均住院时间为11.8天。31例皮瓣中有29例完全存活（93.5%）。在1例成功的皮瓣中（3.2%），患者离开手术室后需要进行探查。仅1例发生严重感染，该例为2例皮瓣失败病例之一。31例患者中有27例重返工作岗位，其中18例回到原工作岗位。
