Salibian A H, Anzel S H, Mallerich M M, Tesoro V E
J Hand Surg Am. 1984 Nov;9(6):799-804. doi: 10.1016/s0363-5023(84)80051-9.
Three patients with compound defects in the distal forearm resulting from close-range gunshot injuries were treated with a free microvascular composite groin flap. The composite flap, which consisted of groin skin, the iliac crest, and abdominal muscles, was used to cover the exposed nerves, tendons, and vessels in one stage. The iliac crest replaced the segmental radial and ulnar defects, and the attached muscles were placed deep to the tendons to provide a gliding surface and to prevent adhesions to the bone. "Sandwiching" the damaged nerves and tendons between highly vascular soft tissue has the potential to improve tendon excursion, nerve regeneration, and ultimately the functional result in the hand. This microvascular reconstruction is presented as an alternative to conventional staged skin flap transfer and cancellous bone grafting.
三名因近距离枪伤导致前臂远端复合缺损的患者接受了游离微血管复合腹股沟皮瓣治疗。该复合皮瓣由腹股沟皮肤、髂嵴和腹部肌肉组成，用于一期覆盖暴露的神经、肌腱和血管。髂嵴替代桡骨和尺骨节段性缺损，附着的肌肉置于肌腱深部以提供滑动表面并防止与骨粘连。将受损神经和肌腱“夹”在高血运软组织之间有可能改善肌腱滑动、神经再生，并最终改善手部功能结果。这种微血管重建术是传统分期皮瓣转移和松质骨移植的一种替代方法。
