Metaizeau J P, Gayet C, Schmitt M, Prévot J
Prog Pediatr Surg. 1981;14:209-23.
The main problem in the treatment of complications of deep burns is to cover the defects with skin of good quality. Although many regions can be covered by split skin grafts, it is important that some areas are covered with full thickness skin and subcutaneous fat in order to get an adequate cosmetic and functional result. In these cases rotation flaps or tubed pedical flaps have been frequently used in the past. Tubed pedical flaps are difficult to construct and have many disadvantages. With the aid of microsurgery it is possible to isolate free skin flaps with the vascular bundle supplying the flap with blood. These flaps can be completely removed from the donor area in one operation and can be placed onto the recipient area. After the vessels of the free flap have been anastomosed to the vessels in the recipient area, the function of the transplanted skin will remain normal. The colour of the transplant, its elasticity and its consistency and preserved. These one-stage techniques greatly facilitate the reconstruction after deep burns. In addition, the quality of the skin varies according to the site of the skin flap taken and it is thus possible to chose the type of skin most appropriate to the recipient zone. The authors describe the different types of free skin flaps, mentioning their qualities and their disadvantages. Finally, they discuss which skin flaps are most useful to cover particular skin defects.
深度烧伤并发症治疗中的主要问题是用优质皮肤覆盖缺损。尽管许多部位可用中厚皮片覆盖，但为了获得满意的美容和功能效果，某些区域用全厚皮肤和皮下脂肪覆盖很重要。过去，在这些情况下常使用旋转皮瓣或管状蒂皮瓣。管状蒂皮瓣制作困难且有许多缺点。借助显微外科技术，可以分离带有为皮瓣供血的血管束的游离皮瓣。这些皮瓣可在一次手术中从供区完全取下并移植到受区。将游离皮瓣的血管与受区血管吻合后，移植皮肤的功能将保持正常。移植皮肤的颜色、弹性和质地得以保留。这些一期技术极大地促进了深度烧伤后的重建。此外，皮肤质量因所取皮瓣部位而异，因此可以选择最适合受区的皮肤类型。作者描述了不同类型的游离皮瓣，提及了它们的优点和缺点。最后，他们讨论了哪种皮瓣最适合覆盖特定的皮肤缺损。
