Department of Plastic and Maxillofacial Surgery, UVA Health, 1215 Lee Street, Box 800376, Charlottesville, VA 22903, USA.
Department of Plastic and Maxillofacial Surgery, UVA Health, 1215 Lee Street, Box 800376, Charlottesville, VA 22903, USA.
Clin Plast Surg. 2021 Apr;48(2):267-276. doi: 10.1016/j.cps.2020.12.006. Epub 2021 Jan 29.
Gustilo IIIC injuries of the lower extremity pose a significant challenge to the reconstructive surgeon. Key principles include early vascular repair and serial debridement followed by definitive coverage within 10 days. Primary reconstructive options following vascular repair include the anterolateral thigh flap or the latissimus dorsi muscle flap. Complications include elevated rates of microvascular thrombosis requiring return to the operating room, partial and complete flap loss, and infection. There is also an elevated rate of secondary amputation. However, in spite of higher complication rates, when approached thoughtfully and with an experienced multidisciplinary team, patients can achieve reasonable functional outcomes.
下肢 Gustilo IIIC 型损伤对重建外科医生来说是一个巨大的挑战。关键原则包括早期血管修复和连续清创，然后在 10 天内进行确定性覆盖。血管修复后的主要重建选择包括股前外侧皮瓣或背阔肌皮瓣。并发症包括微血栓形成的发生率升高，需要返回手术室，部分和完全皮瓣坏死，以及感染。也有较高的二次截肢率。然而，尽管并发症发生率较高，但如果经过深思熟虑，并由经验丰富的多学科团队进行处理，患者可以获得合理的功能结果。
