Lai Yu Ming, Tay Kae-Sian, Lee Shaun Qing Wei, Wong Allen Wei-Jiat
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore.
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
J Surg Case Rep. 2022 Aug 11;2022(8):rjac320. doi: 10.1093/jscr/rjac320. eCollection 2022 Aug.
Lower extremity wounds are a healthcare issue that can result in debilitating consequences. Peripheral arterial occlusive disease (PAOD) being a major contributing factor to the disease, advance revascularization procedures (Angioplasty) based on the angiosome concept has been established in the literature to improve blood supply and promote better healing outcomes. We present a case of a 59-year-old lady with background of hypertension, diabetes and PAOD, was diagnosed with a non-healing foot wound with exposed metal implant. She had targeted angioplasty done based on angiosome concept followed by early local flap reconstruction for coverage, which healed well without complications. Although free tissue transfer has now been the mainstay for lower limb reconstruction with the advancement in microsurgery. Local flaps remain in the armamentarium of lower extremity reconstruction with small to medium sized wound defects. This case demonstrates the advantage of proceeding with immediate-early local flap reconstruction following successful targeted re-vascularization.
下肢伤口是一个可能导致使人衰弱后果的医疗问题。外周动脉闭塞性疾病(PAOD)是该疾病的一个主要促成因素,基于血管体概念的先进血管重建手术(血管成形术)在文献中已被确立,以改善血液供应并促进更好的愈合结果。我们报告一例59岁女性病例,她有高血压、糖尿病和PAOD病史,被诊断为足部伤口不愈合且金属植入物外露。她基于血管体概念进行了靶向血管成形术,随后进行早期局部皮瓣重建以覆盖创面,创面愈合良好且无并发症。尽管随着显微外科的发展,游离组织移植现已成为下肢重建的主要方法。对于中小面积伤口缺损的下肢重建,局部皮瓣仍然是可用的方法。本病例展示了在成功进行靶向血管重建后立即进行早期局部皮瓣重建的优势。