Schrire Timothy, Din Asmat H, Khan Umraz
Plastic Surgery, Southmead Hospital, Bristol, GBR.
Plastic and Reconstructive Surgery, Southmead Hospital, Bristol, GBR.
Cureus. 2021 Feb 18;13(2):e13427. doi: 10.7759/cureus.13427.
Major trauma care has improved in the UK since the evolution and acceptance of specialist centers . A mission statement for major trauma care is "reduction in mortality and disability following trauma." The care for extremity trauma has benefited from this specialization. Traumatic loss of skin integument in the extremities, especially over mobile joints, may lead to a compromised functional outcome. Modern reconstructive plastic surgery aims to provide flaps with minimal donor site morbidity. In this case report, we present the use of two chimeric flaps undertaken sequentially (one acutely and the second delayed) around the knee joint to allow a greater range of motion and function after a severe traumatic event. In this clinical case, the original tissue defects had meant that a free flap was used to reconstruct an open fractured bone, and split skin grafting was undertaken on the anterior aspect of the knee. The latter was then replaced after some months of recovery.
自专科中心发展并被认可以来，英国的重大创伤护理水平有所提高。重大创伤护理的使命宣言是“降低创伤后的死亡率和残疾率”。肢体创伤护理受益于这种专业化。肢体皮肤覆盖层的创伤性缺失，尤其是在活动关节处，可能导致功能结果受损。现代重建整形外科旨在提供供区发病率最小的皮瓣。在本病例报告中，我们展示了在膝关节周围依次采用两个嵌合皮瓣（一个急诊使用，另一个延迟使用），以在严重创伤事件后实现更大范围的活动和功能。在这个临床病例中，最初的组织缺损意味着使用游离皮瓣来重建开放性骨折，并且在膝关节前方进行了分层皮片移植。几个月的恢复后，后者被替换。
