Weinzweig N
Division of Plastic Surgery, University of Illinois at Chicago, USA.
Plast Reconstr Surg. 1995 Sep;96(4):972-7. doi: 10.1097/00006534-199509001-00033.
Gangrene of an extremity secondary to a congenital constriction band may result from in utero or postnatal vascular compromise. Often ths process is completed in utero following spontaneous resolution of the vascular insufficiency, resulting in a healed wound by fetal repair and regeneration or in amputation of the distal part. When this process is progressive as a result of worsening lymphaticovenous and/or arterial obstruction with associated soft-tissue necrosis, salvage of the distal part can be accomplished by immediate decompression to evacuate the lymphedema fluid, staged band excision, Z-plasty closure, and topical antimicrobial therapy of the open wound. A revised classification of constriction-ring syndrome incorporating the "intermediate" stage (3B) of severe lymphaticovenous compromise with soft-tissue loss is introduced.
先天性束带继发的肢体坏疽可能源于宫内或出生后的血管受损。通常，该过程在宫内完成，继血管功能不全自然缓解后，通过胎儿修复和再生形成愈合伤口，或导致远端部分截肢。当由于淋巴静脉和/或动脉阻塞加重并伴有软组织坏死而使该过程进展时，可通过立即减压以排出淋巴水肿液、分期切除束带、Z形皮瓣闭合以及对开放伤口进行局部抗菌治疗来挽救远端部分。引入了一种修订后的束带综合征分类方法，纳入了伴有软组织缺失的严重淋巴静脉损害的“中间”阶段（3B）。
