Stompro B E, Stevenson T R
Division of Plastic Surgery, University of California, Davis Medical Center, Sacramento.
Plast Reconstr Surg. 1994 Apr;93(5):1021-5; discussion 1026-7.
Microvascular free-tissue transfer is often employed to achieve limb salvage in traumatic leg wounds. Previous experience has shown that one cause of flap failure is placement of the microvascular anastomoses within the zone of injury and subsequent thrombosis. This observation has prompted surgeons to perform anastomoses on the proximal uninjured recipient vessels. However, access to the vessels distal to the injury site is often technically easier. An assessment was made of 23 free flaps used for leg reconstruction to evaluate the success of performing microvascular anastomoses distal to the zone of injury. Twenty-one flaps with distal anastomoses were successful (91 percent). Distally based free-flap reconstruction provides an acceptable alternative to the commonly employed proximal approach.
微血管游离组织移植常用于修复创伤性腿部伤口以挽救肢体。以往经验表明，皮瓣失败的一个原因是微血管吻合口位于损伤区域内，随后发生血栓形成。这一观察结果促使外科医生在近端未受伤的受区血管上进行吻合。然而，在损伤部位远端的血管进行吻合在技术上通常更容易。对23例用于腿部重建的游离皮瓣进行了评估，以评估在损伤区域远端进行微血管吻合的成功率。21例采用远端吻合的皮瓣成功（91%）。基于远端的游离皮瓣重建为常用的近端方法提供了一种可接受的替代方案。
