受区炎性疤痕吻合血管游离皮瓣移植术中的血管处理

目的探讨受区炎性疤痕吻合血管游离皮瓣移植术中的血管的正确判断和处理方法,提高游离皮瓣手术的成功率。方法受区炎性疤痕,需行游离皮瓣修复7例,其中桥式交叉吻合1例,血管移植3例,扩大清创至正常区域吻合3例。结果所有皮瓣均完全存活,未出现血管危象,术后功能恢复良好。结论受区慢性感染所致的炎性疤痕内的血管不可行血管吻合,吻合处应位于正常组织内,以提高皮瓣存活率,减少术后血管危象发生。

Disposal of the vascular pedicle in inflammatory scar of recipient region in reconstruction with free flap of anastomosed blood vessel

ve In the reconstruction with free flap of anastomosed blood vessel, correct judgment and disposal of the vascular pedicle in inflammatory scar tissue of recipient region will be advantageous to increase the rate of success of operation. Methods From July, 1995 to July, 1997,7 case reconstruction with free flap have been finished: In which the vascular pedicles of the recipient region in inflammatory scar tissue were disposed differently, including 1 cases of bridge cross, 3 cases of vascular grafting and 3 cases of vascalar anastomosis at normal area followed by enlarging debridement. Results The operations were all successful on their first without the postoperative vascular crisis. Conclusion The blood vessel pedicle of the recipient region of inflammatory scar caused by chronic infection can not be used to anastomse. The vascular anastomosis must be performed at the normal tissue area so as to increase the survival ratio of free flap and decrease the postoperative vascular crisis.