Swartz W M, Mears D C
Plast Reconstr Surg. 1985 Sep;76(3):364-73. doi: 10.1097/00006534-198509000-00005.
Eighty-five free flaps were performed in 76 patients for defects in the lower extremity. A new classification of lower-extremity defects was devised to help define the role of free-tissue transfers: group 1, soft-tissue defects; group 2, soft-tissue and bone loss less than 8 cm; group 3, massive soft-tissue and bone loss greater than 8 cm; and group 4, bone defect only. Each group was further divided into clean (A) and infected (B) wounds. Our overall results include resolution of the presenting problem in 82 percent; there were 17 flap losses (20 percent), persistent osteomyelitis in 8, and 10 amputations. This review has prompted us to limit our indications for limb salvage, particularly in group 3B, in patients with compound injuries that include loss of plantar sensation, and in patients with large segments of infected bone.
对76例下肢缺损患者实施了85例游离皮瓣移植术。设计了一种新的下肢缺损分类方法，以帮助明确游离组织移植的作用：第1组，软组织缺损；第2组，软组织和骨缺损小于8厘米；第3组，大面积软组织和骨缺损大于8厘米；第4组，仅骨缺损。每组又进一步分为清洁伤口（A）和感染伤口（B）。我们的总体结果包括82%的患者当前问题得到解决；有17例皮瓣坏死（20%），8例持续性骨髓炎，10例截肢。这项综述促使我们限制保肢手术的适应证，特别是在3B组、伴有足底感觉丧失的复合伤患者以及有大片感染骨的患者中。
