Saritas Sinem, Jul Kiil Birgitte, Sværdborg Mille
From the Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark.
Plast Reconstr Surg Glob Open. 2023 Aug 14;11(8):e5195. doi: 10.1097/GOX.0000000000005195. eCollection 2023 Aug.
Degloving traumatic lower extremity injuries can lead to an above-knee amputation with decreased functional capacity compared with below-knee amputation. The unique properties of the deep inferior epigastric artery perforator flap providing a substantial amount of skin and subcutaneous tissue combined with reliability and low donor-site morbidity makes the flap ideal for coverage of below-knee amputation stumps when soft tissue is required. A bipedicled four-zone deep inferior epigastric artery perforator flap with a skin area of 13 × 33 cm was used as coverage of a degloved lower leg amputation stump, in a 27-year-old woman with a left-sided Gustillo type 3B comminute diaphyseal tibial fractur and major degloving injury. Hereby, above-knee amputation was avoided. Ten months postoperatively the patient had achieved full prosthetic function.
与膝下截肢相比，脱套性创伤性下肢损伤可能导致膝上截肢，功能能力下降。腹壁下深动脉穿支皮瓣具有独特的特性，能提供大量皮肤和皮下组织，兼具可靠性和供区发病率低的特点，使其成为在需要软组织时覆盖膝下截肢残端的理想皮瓣。一名27岁女性，左侧胫骨骨干Gustillo 3B型粉碎性骨折并严重脱套伤，采用了皮肤面积为13×33 cm的双蒂四区腹壁下深动脉穿支皮瓣覆盖小腿脱套截肢残端。借此，避免了膝上截肢。术后十个月，患者实现了完全的假肢功能。
