Kaplan I, Ada S, Ozerkan F, Bora A, Ademoglu Y
Hand and Microsurgery Hospital, Kahramanlar, Izmir, Turkey.
Microsurgery. 1998;18(3):176-81. doi: 10.1002/(sici)1098-2752(1998)18:3<176::aid-micr10>3.0.co;2-v.
This article reports our experiences treating soft tissue and bone defects in the lower extremity with free flaps. One of the most common causes for lower extremity wounds are high-energy injuries. These kinds of injuries contain soft tissue and bone defects beyond neurovascular complications. The rate of infection and nonunion is very high in these injuries. Between 1988 and 1996, we applied 33 flaps to 28 patients. The numbers and kinds of the free flaps are as follows: 12 latissimus dorsi, nine radial forearm, seven lateral arm, three vascularised fibula grafts with skin, one gracilis, and one medial plantar flap. Three free flaps were lost (12%). The success rate is 88%. The advantage of free flaps is that they allow the reconstruction of the large defects in one-session operations. Thus, they decrease the rate of infection and increase that of nonunion. The patient returns to his active life at an earlier stage.
本文报道了我们使用游离皮瓣治疗下肢软组织和骨缺损的经验。下肢伤口最常见的原因之一是高能损伤。这类损伤包含软组织和骨缺损，还伴有神经血管并发症。这些损伤的感染率和骨不连发生率非常高。1988年至1996年间，我们对28例患者应用了33个皮瓣。游离皮瓣的数量和种类如下：12个背阔肌皮瓣、9个桡侧前臂皮瓣、7个上臂外侧皮瓣、3个带皮肤的血管化腓骨移植瓣、1个股薄肌皮瓣和1个足底内侧皮瓣。3个游离皮瓣失败（12%）。成功率为88%。游离皮瓣的优点是可以在一期手术中修复大的缺损。因此，它们降低了感染率，提高了骨不连率。患者能更早地恢复正常生活。
