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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Bipedicled flaps in posttraumatic lower-extremity reconstruction
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Bipedicled flaps in posttraumatic lower-extremity reconstruction

机译：创伤后下肢重建中的双蒂皮瓣

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Background Complex, lower-extremity, soft-tissue defects pose a significant challenge to the reconstructive surgeon and often require the use of free flaps, which puts significant demands on the patient, the surgeon and the health-care system. Bipedicled flaps are random but receive a blood supply from two pedicles, allowing the surgeon to use local tissue with an augmented nutrient blood flow. They are simple to elevate and economical in operating time. This study describes our experience with lower-extremity wound reconstruction using the bipedicled flap as an alternative to pedicled flaps and free flaps. Methods Ten patients with lower-extremity defects underwent bipedicled flap reconstruction. Operative times, length of stay following flap procedure and postoperative complications were documented. Data were collected in a prospective fashion. Results Two patients had minimal areas of flap necrosis, both of which resolved with conservative local wound care and one patient developed a postoperative wound infection remedied with a course of oral antibiotics. We experienced one major complication involving wound dehiscence requiring an additional flap. Conclusions Bipedicled flaps provide a safe, fast and relatively easy alternative for coverage of certain complex open wounds in the lower extremities. Their use does not preclude the use of more traditional options of pedicled muscle or free flap coverage at a later time should they be required. Clinical questions addressed/Level of evidence: What are alternative strategies for lower-extremity wound reconstruction. Level of Evidence V.
机译：背景技术复杂，下肢软组织缺损对重建外科医师提出了重大挑战，并且经常需要使用自由瓣，这对患者，外科医师和医疗保健系统提出了重大要求。双瓣皮瓣是随机的，但从两个蒂获得血液供应，使外科医生可以使用营养血流增加的局部组织。它们易于提升并且在操作时间上经济。这项研究描述了我们使用双蒂皮瓣替代蒂皮瓣和游离皮瓣进行下肢伤口重建的经验。方法对10例下肢缺损患者行双蒂皮瓣重建术。记录手术时间，皮瓣手术后的住院时间和术后并发症。数据以预期方式收集。结果2例患者的皮瓣坏死面积极小，均通过保守的局部伤口护理得以解决，1例患者发生了术后伤口感染，并经口服抗生素治疗。我们经历了一次涉及伤口裂开的主要并发症，需要额外的皮瓣。结论双蒂皮瓣为下肢某些复杂的开放性伤口的覆盖提供了一种安全，快速且相对容易的替代方法。他们的使用并不排除在以后需要时使用更传统的椎弓根肌肉或游离皮瓣覆盖物。解决的临床问题/证据水平：下肢伤口重建的替代策略是什么？证据级别V.

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