大段骨与大面积皮肤复合缺损的显微外科修复

总结用于一期修复肢体大段骨与大面积软组织复合缺损的显微外科技术及其临床应用效果。方法１９例用背阔肌肌皮瓣与腓骨组合移植，２例用双侧背阔肌肌皮瓣与腓骨组织移植来修复下肢和上肢的骨与皮肤复合缺损，其中１６例采用桥式交叉吻合血管的方式重建移植组织的血液循环。

Microsurgery repair of composite defects of segmental bone and large-area skin of the extremities

Objective To report a microsurgical technique for repairing composite defects of segmental bone and large area skin of the extremities and the results of its clinical application. Methods To repair composite bone and skin defects of the upper (one case) and lower (20 cases) extremities, combined transplantation of latissimus dorsi myocutaneous flap and vascularized fibula was performed in 19 cases and combined transplantation of bilateral latissimus dorsi myocutaneous flaps and vascularized fibula in two. In 16 cases the blood circulation in the transplanted tissues was reestablished by cross bridge vascular anastomosis. Results All the transplants survived, the transplanted fibulas united with the host bones within 4 months postoperatively. Averaged follow up period 2 years and 3 months, revealsed the repaired limbs had restored their useful function. Conclusions Combined transplantation of latissimus dorsi myocutaneous flap(s) and vascularized fibula is an effective method for repairing composite bone and skin defects of the extremities when indicated.(Shanghai Med J. 1999,22:134 136)