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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Salvage of free flaps by supermicrosurgical techniques following accidental rupture of the perforator pedicle
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Salvage of free flaps by supermicrosurgical techniques following accidental rupture of the perforator pedicle

机译：穿孔性椎弓根意外破裂后通过超显微外科手术技术修复游离皮瓣

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摘要

Dear Sir, Perforator flaps have gained immense popularity recently, because they reduce donor site morbidity and increase cosmesis. Despite meticulous dissection when elevating a perforator flap, injury to the perforator may occur. We have experience of five cases of accidental rupture of the perforator pedicle during pedicle dissection, and in all cases the pedicle was repaired using supermicrosurgical techniques. This study includes all cases of perforator rupture during flap dissection in the experience of the senior surgeon (J.T.K.). Electronic charts were reviewed where available. Patient demographics, type of flap, cause of perforator rupture, solution used to mend the rupture, and postoperative complications were recorded. There were five cases of accidental perforator pedicle injury during flap dissection, all of which were repaired by supermicrosurgical techniques. Details of the patients and their flaps are given in Table 1. A 30-year-old male patient had an extensive soft tissue defect of the right upper arm due to necrotizing fasciitis. Resurfacing was planned using an anterolateral thigh free flap. The surgery was performed by an inexperienced surgeon, and two perforator pedicles were dissected from the flap proximally to the muscle level, where the surgeon could not perform further intramuscular dissection. Then retrograde dissection of the flap from the descending branch of the lateral circumflex femoral artery was carried out. However, the two perforators dissected from the flap and the main pedicle did not meet and were severed at the perforator level, with two perforator arteries and veins on each side. The dissected recipient vessels were the ulnar artery and a superficial vein.
机译：亲爱的主席先生，穿孔皮瓣近来广受欢迎，因为它们减少了供体部位的发病率并增加了美容效果。尽管在抬高穿孔器瓣时进行了细致的解剖，但可能会损坏穿孔器。我们有5例在椎弓根剥离期间意外穿孔的椎弓根破裂的经验，在所有情况下，均使用超显微外科技术修复了椎弓根。这项研究包括资深外科医师（J.T.K.）的经验，包括皮瓣剥离过程中所有穿孔器破裂的病例。对电子海图进行了审查（如果可用）。记录患者的人口统计资料，皮瓣类型，穿孔器破裂的原因，用于修补破裂的溶液以及术后并发症。皮瓣剥离过程中意外穿孔的椎弓根有5例，均通过超显微外科手术技术修复。患者及其皮瓣的详细情况见表1。一名30岁的男性患者因坏死性筋膜炎而右上臂广泛出现软组织缺损。计划使用大腿前外侧游离皮瓣进行换肤。手术由经验不足的外科医生进行，从皮瓣的近端至肌肉水平切开两个穿孔的椎弓根，此时外科医生无法进行进一步的肌肉内解剖。然后从外侧回旋股动脉的降支进行皮瓣逆行解剖。但是，从皮瓣上切下的两个穿孔器和主蒂没有汇合，并在穿孔器水平处被切断，每侧有两个穿孔器动脉和静脉。解剖的接受血管是尺动脉和浅静脉。

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