Weinzweig N, Schuler J, Vitello J
Department of Surgery, University of Illinois at Chicago, USA.
Plast Reconstr Surg. 1997 Mar;99(3):757-62. doi: 10.1097/00006534-199703000-00024.
Simultaneous resurfacing of extensive soft-tissue defects involving both lower extremities can be performed successfully with free hemiflaps harvested from the omentum. This avoids the need for staged operations or for separate donor sites with the concomitant morbidities, the possible need for intraoperative repositioning, and the significantly greater operative time. During the past 3 years, six omental free hemiflaps were performed in three patients for bilateral lower limb reconstruction. All patients had extensive ulcerations, averaging 207.5 cm2 in surface area. Ulcerations were secondary to either homozygous sickle cell anemia (two patients) or chronic venous insufficiency (one patient). Operative time averaged 11 hours for the bilateral procedures. Delayed skin grafting was performed in two patients. All six omental free hemiflaps were successful. Partial skin-graft loss due to infection occurred in both sickle cell anemia patients. Significant improvement in symptoms was noted in all patients. There were no donor-site complications. Free hemiflaps harvested from the omentum can provide sufficient well-vascularized tissue with large-caliber vessels for coverage of separate extensive soft-tissue defects in one operation with minimal donor-site morbidity, making this an ideal flap option when multiple sites are involved.
利用从大网膜获取的游离半侧皮瓣，可成功同时修复累及双下肢的大面积软组织缺损。这避免了分期手术或使用伴有相应并发症的不同供区，避免了术中可能需要重新定位的情况，以及显著更长的手术时间。在过去3年中，为3例患者进行了6例大网膜游离半侧皮瓣移植以重建双侧下肢。所有患者均有大面积溃疡，平均表面积为207.5平方厘米。溃疡继发于纯合子镰状细胞贫血（2例患者）或慢性静脉功能不全（1例患者）。双侧手术的平均手术时间为11小时。2例患者进行了延迟植皮。所有6例大网膜游离半侧皮瓣移植均成功。镰状细胞贫血患者均出现因感染导致的部分植皮丢失。所有患者的症状均有显著改善。未出现供区并发症。从大网膜获取的游离半侧皮瓣可提供足够的、带有大口径血管的血运丰富的组织，在一次手术中覆盖多个单独的大面积软组织缺损，供区发病率极低，这使其成为涉及多个部位时的理想皮瓣选择。
