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首页> 外文期刊>Medical science monitor : >Free flap transplantation combined with skin grafting and vacuum sealing drainage for repair of circumferential or sub-circumferential soft-tissue wounds of the lower leg
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Free flap transplantation combined with skin grafting and vacuum sealing drainage for repair of circumferential or sub-circumferential soft-tissue wounds of the lower leg

机译：游离皮瓣移植结合皮肤移植和真空密封引流修复小腿周围或半周软组织伤口

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Background This study is aimed at evaluating the operation techniques and clinical significance of free flap transplantation combined with skin grafting and vacuum sealing drainage (VSD) in repairing severe traumatic extensive circumferential or semi-circumferential soft-tissue defects of the lower leg. Material and Methods Thirty patients with severe lower leg injuries were treated by free flap transplantation combined with skin grafting and VSD from January 2008 to June 2011. The size of the wounds ranged from 23×8 cm to 44×28 cm and all affected more 70% of the low leg circumferential area. Wounds were complicated by exposure, necrosis, or infection of deep tissues. The wounds were first debrided and covered by VSD. When the condition of the wound had improved (5 to 7 days later), free flaps were harvested to reconstruct damaged tissue and skin grafts and VSD was used to cover granulation tissues around the transplanted flap. Results Granulation tissues developed and the area requiring flap cover decreased in all 30 patients after debridement and VSD. In 28 of 30 cases, the transplanted flaps grew well without complication. Peripheral necrosis was observed in only 2 cases, which required a second debridement and skin graft. Ten wound areas covered by grafts were left with scattered peripheral wounds, which healed with the help of 1 more skin graft or dressing change. Morphological appearance and functional recovery were satisfactory in all 30 cases. Conclusions Initial debridement and the temporary VSD cover followed after several days by free flap transplantation combined with skin grafting and VSD protection is a reliable treatment regimen for traumatic large circumferential or sub-circumferential soft tissue wounds of the lower leg with deep tissue exposure.
机译：背景技术本研究旨在评估游离皮瓣移植结合皮肤移植和真空密封引流术（VSD）修复小腿严重外伤性广泛圆周或半周软组织缺损的手术技术和临床意义。材料与方法自2008年1月至2011年6月，采用游离皮瓣移植结合皮肤移植和VSD对30例小腿严重受伤的患者进行了治疗。伤口的大小从23×8 cm到44×28 cm不等，全部受影响70小腿周围区域的百分比。伤口因暴露，坏死或感染深层组织而变得复杂。首先清创伤口并用VSD覆盖。当伤口状况得到改善（5至7天后）时，收集游离皮瓣以重建受损的组织和皮肤移植物，并使用VSD覆盖移植皮瓣周围的肉芽组织。结果清创和VSD后所有30例患者均出现肉芽组织生长，需要皮瓣覆盖的区域减少。 30例中的28例，移植皮瓣生长良好，无并发症。仅2例观察到周围坏死，需要第二次清创术和皮肤移植。十个被移植物覆盖的伤口区域留有分散的周围伤口，在另外1个皮肤移植物或敷料更换的帮助下可以治愈。所有30例的形态学外观和功能恢复均令人满意。结论最初的清创术和临时的VSD覆盖，几天后免费皮瓣移植，皮肤移植和VSD保护相结合，是治疗小腿深部周围或周围半周软组织创伤并深层组织暴露的可靠治疗方案。

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