上肢大面积皮肤缺损合并感染的显微外科治疗

目的 探讨上肢大面积皮肤缺损合并感染的临床特点，治疗方法及预后等相关因素。方法 对6例上肢大面积皮肤缺损合并感染的患者，采用股前外侧皮瓣游离移植3例，背阔肌皮瓣转位1例，预制骨间背动脉逆行岛状皮瓣2例（其中1例同时用腹股沟皮瓣）。结果 6例皮瓣全部存活，感染得到有效的控制。结论 对于上肢大面积皮肤缺损合并感染的患者，在控制感染的基础上，用皮瓣移植（或移位）覆盖创面是最有效的治疗方法。

Microsurgical treatment of upper extremity infections with large-size soft tissue defects

Objective To discuss the clinical features, treatment and prognosis of upper extremity infections with large-size soft tissue defects. Methods 6 cases of upper extremity infections with large-size soft-tissue defects were treated from March 1999 to October 2003. After meticulous control of the infection and careful debridement, various flaps were transferred to cover the defects. There were 3 free anterolateral thigh flaps, 1 lattissimus dorsi myocutaneous flap, and 2 prefabricated posterior interosseous artery flaps (in 1 of the 2 cases, an additional groin flap was necessary). Results All flaps survived. Infection of the wound subsided. Good coverage of the defects was obtained. Conclusion Flap transfer is an effective method to treat upper extremity infections with large-size soft tissue defects.