预防生物废物产生：在创伤性下肢中有效利用存活组织。
Preventing biological waste: Effective use of viable tissue in traumatized lower extremities.
作者信息
Lansford Jefferson L, McCarthy Conor F, Souza Jason M, Saberski Ean R, Potter Benjamin K
机构信息
Walter Reed National Military Medical Center, Bethesda, MD.
Ohio State University College of Medicine, Columbus, OH; and.
出版信息
OTA Int. 2023 Jul 11;6(4 Suppl):e242. doi: 10.1097/OI9.0000000000000242. eCollection 2023 Jul.
UNLABELLED
Severe open lower extremity trauma requires debridement to remove contamination and devitalized tissues. Aggressive debridement should be balanced with preservation of viable tissue. These often damaged but preserved viable tissues are "spare parts" that augment the options available for reconstruction. The long-term goal of reconstruction should be functional limb restoration and optimization. Injury patterns, levels, and patient factors will determine whether this endeavor is better accomplished with limb salvage or amputation. This article reviews the rationale and strategies for preserving spare parts throughout debridement and then incorporating them as opportunistic grafts in the ultimate reconstruction to facilitate healing and maximize extremity function.
LEVEL OF EVIDENCE
未标注
严重的开放性下肢创伤需要进行清创以清除污染物和失活组织。积极的清创应与保留存活组织相平衡。这些常受损但仍存活的组织是“备用部件”，可增加重建的选择。重建的长期目标应是恢复肢体功能并使其最优化。损伤模式、部位及患者因素将决定通过保肢还是截肢能更好地实现这一目标。本文回顾了在整个清创过程中保留备用部件并随后将其作为机会性移植物纳入最终重建以促进愈合和最大化肢体功能的基本原理及策略。
证据等级
5级。
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