岛状皮瓣在下肢复合伤中的应用

目的 选择合适的皮瓣,在适当的时机,修复复合伤及组织缺损。方法 笔者通过术前DSA造影的辅助手段选择了9种不同方式的皮瓣移植．修复了54例下肢不同部位、不同面积的软组织缺损。结果 54例皮瓣手术,其皮瓣切取成功率100％．远期成活率96．3％。2例失败病例都属足踝上“严重创伤”濒临截肢的病人．DSA造影已显示主干血管均损伤,末梢仍有微弱血运．行健肢平行桥式胫后动脉逆行岛状皮瓣移植．皮瓣成活。但患足坏死致“无效皮瓣移植”。结论 对于“严重创伤”．皮瓣移植的最好时机是在坏死界线刚清楚,感染还未发生时进行。DSA造影选择皮瓣供区比以往凭经验和超声多普勒探测更科学、更直观。

The island flap being application in the compound wound of lower limbs

Objective Selecting suitable flap , on suitable opportunity , to repair compound wound and organization . Methods The supplementary means by way of DSA's radiography before operation. the author had selected flap of 9 kinds of different methods to transplant , they had repaired the 54 examples different positions of lower limbs and the soft tissue of different areas . Results Taking flap's success rate was 100%, at a specified future date survival rate was 96.3%. 2 defeat cases belongs on the sufficient ankle patient that " serious wound " bordered on the amputation , DSA's radiography had shown the trunk blood vessel all to be harmed , and the tip still had faint blood ,to use healthy limb parallel bridge type island flap transplanting , flap survives , but tips suffer from sufficient necrosis sends " invalid flap transplants ". Conclusion The author knows from experience as for " serious wound " , and the best opportunity that flap transplants is clear just in the necrosis boundary line , and infects being in progress when still not occurring . DSA's radiography selects the flap area to lean on experience and ultrasound detection more science and more directly perceived than before .