Moosa H H, Peitzman A B, Thompson B R, Webster M W, Steed D L
J Vasc Surg. 1985 Jul;2(4):610-2.
Arteriovenous fistulas constructed with an interposed segment of expanded polytetrafluoroethylene (PTFE) have been used successfully for long-term hemodialysis, but ultimately these fistulas may fail because of graft thrombosis, infection, or pseudoaneurysm. A PTFE graft may become exposed from skin necrosis at an area of repeated puncture for hemodialysis or from wound breakdown at a site of thrombectomy. Removal of an exposed PTFE graft has heretofore been considered inevitable, especially if a suture line is involved, because of the risk of hemorrhage and infection. We describe coverage of an exposed graft by a simple full-thickness skin flap that is locally rotated and report the successful salvage of five fistulas by this technique. Thus the concept that an exposed graft is infected and must be removed may not always be correct.
采用一段插入的膨体聚四氟乙烯（PTFE）构建的动静脉内瘘已成功用于长期血液透析，但最终这些内瘘可能会因移植血管血栓形成、感染或假性动脉瘤而失败。PTFE移植血管可能会因血液透析反复穿刺部位的皮肤坏死或血栓切除术部位的伤口破裂而暴露于皮肤表面。迄今为止，由于存在出血和感染风险，移除暴露的PTFE移植血管一直被认为是不可避免的，特别是如果涉及缝合线时。我们描述了一种通过局部旋转的简单全厚皮瓣覆盖暴露移植血管的方法，并报告了通过该技术成功挽救5例内瘘的情况。因此，认为暴露的移植血管已感染且必须移除的观念可能并不总是正确的。
