股薄肌肌皮瓣:糖尿病足重建中的“主力”游离皮瓣

The Gracilis Muscle Flap: A "Work Horse" Free Flap in Diabetic Foot Reconstruction.

作者信息

Shyamsundar Skanda, Mahmud Ali Adil, Khalasi Vishal

机构信息

Head of department plastic surgery, Kauvery hospital, Trichy, Tamil Nadu, India.

Consultant plastic surgeon, department plastic surgery, Kauvery hospital, Trichy, Tamil Nadu, India.

出版信息

World J Plast Surg. 2021 May;10(2):33-39. doi: 10.29252/wjps.10.2.33.

Abstract

BACKGROUND

Diabetes is a leading cause of foot ulcers and lower limb amputation throughout the world. Adequate wound debridement and cover is the standard of care, but lack of adequate vascularised local tissue poses a major challenge. The gracilis flap offers various advantages in this respect, which we would like to discuss in this study, and hence makes it an attractive option in diabetic foot patients.

MATERIAL AND METHODS

This retrospective study was conducted over a period of 2 years, from 2018 to 2020 in the Department of Plastic Surgery, Kauvery Hospital, Trichy, India. The flap harvest time, total operation time, flap take and complications associated with the procedure were noted.

RESULTS

Overall, 56 patients were enrolled. The average flap harvest time was 55 +/- 10 min and the average overall operation time was 240+/- 30 minutes. There was complete flap survival in 42 (75%) patients, a partial survival in 12 (21.42%) patients and complete flap loss in 2 (3.57%) patients. In the donor site complications hypertrophic scarring was reported in 5 (8.92%) and donor site seroma in 3(5.3%) patients.

CONCLUSION

The free gracilis flap offers good wound healing and excellent foot contour besides being safe and effective in small to medium sized defects makes it an excellent free flap in diabetic foot reconstruction.

摘要

背景

糖尿病是全球足部溃疡和下肢截肢的主要原因。充分的伤口清创和覆盖是治疗的标准,但缺乏足够的带血管蒂局部组织是一个重大挑战。股薄肌皮瓣在这方面具有多种优势,我们将在本研究中进行讨论,因此使其成为糖尿病足患者的一个有吸引力的选择。

材料与方法

这项回顾性研究于2018年至2020年在印度蒂鲁吉里考维里医院整形外科进行,为期2年。记录皮瓣切取时间、总手术时间、皮瓣成活情况以及与该手术相关的并发症。

结果

总共纳入了56例患者。平均皮瓣切取时间为55±10分钟,平均总手术时间为240±30分钟。42例(75%)患者皮瓣完全成活,12例(21.42%)患者部分成活,2例(3.57%)患者皮瓣完全坏死。在供区并发症方面,5例(8.92%)患者出现增生性瘢痕,3例(5.3%)患者出现供区血清肿。

结论

游离股薄肌皮瓣除了在中小面积缺损中安全有效外,还能实现良好的伤口愈合和出色的足部外形,使其成为糖尿病足重建中一种优秀的游离皮瓣。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd8/8290442/99ba8974b7a2/wjps-10-033-g001.jpg

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