Department of Plastic Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, First Floor PHC Plastic Surgery, Washington, DC 20007, USA. Electronic address: https://twitter.com/JBekeny.
Department of Plastic Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, First Floor PHC Plastic Surgery, Washington, DC 20007, USA. Electronic address: https://twitter.com/ezolper.
Clin Plast Surg. 2021 Apr;48(2):321-329. doi: 10.1016/j.cps.2021.01.004. Epub 2021 Feb 10.
Chronic lower extremity wounds are defined as wounds that fail to heal within 3 months of defect onset. Free tissue transfer offers an opportunity for limb salvage and length preservation. Preoperative optimization includes a medical and nutritional consult, complete work-up by vascular surgery, and an analysis of bony stability and gait biomechanics by podiatric surgery. In the authors' practice, the thigh has proved the workhorse donor site and offers fasciocutaneous and muscle-based flaps depending on defect characteristics. Postoperative care requires early monitoring for flap compromise and continued long-term follow-up for wound recurrence.
慢性下肢创伤是指在发病后 3 个月内无法愈合的创伤。游离组织移植为肢体保全和长度保留提供了机会。术前优化包括医疗和营养咨询、血管外科的全面检查，以及足病外科对骨骼稳定性和步态生物力学的分析。在作者的实践中，大腿已被证明是理想的供体部位，并可根据创伤特点提供筋膜皮瓣和肌皮瓣。术后护理需要早期监测皮瓣是否受损，并持续进行长期随访以观察伤口是否复发。
