Reconstruction of Complex Defects of Lower Extremities Using Thinned Free Muscle Flaps
Reconstruction of Complex Defects of Lower Extremities Using Thinned Free Muscle Flaps
复制标题
薄化游离肌瓣重建下肢复杂缺损
DOI：
10.1007/s00266-016-0641-x
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发表时间：
2016-05
期刊：
影响因子：
--
通讯作者：
Guo S
中科院分区：
文献类型：
--
作者：
Song B;Chen J;Han Y;Li Y;Su Y;Guo S
研究背景游离肌瓣表面覆盖后，外观臃肿是一个主要缺点。转移时的一期减薄程序可以改善外观，避免额外的减瘤手术。我们提出了我们的经验，在复杂的下肢缺损的重建减薄的游离muscle flaps.MethodsLatissimus背阔肌肌皮瓣（LDMs）和腹直肌皮瓣（RAMs），其中有血管蒂运行在肌肉深处，提高和浅表组织层去除薄皮瓣。这些变薄的肌肉皮瓣，然后用于重新表面上的伤口下肢，然后覆盖皮肤自体移植物上的肌肉surfaces.Results14 LDMs和4 RAM变薄用于重新表面上的八个，五个，和三个缺陷的脚，踝关节，胫骨前区，分别与伤口，范围从6 × 4 cm 2到23 × 9 cm 2。所有肌瓣均顺利通过切线减薄手术。除了一例皮肤部分缺损外，大多数皮肤移植物的移植率都很高。在1-20个月的后续行动中，皮肤表面轮廓在变薄的肌肉皮瓣匹配以及与邻近areas.ConclusionsIntraoperative立即变薄的LDMs和RAM可以安全地完成在主要的重建程序，并可能提供一种替代复盖复杂的下肢defects.Level of Evidence VThis期刊要求作者分配一个级别的证据，每篇文章。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明 www.springer.com/00266 .
BackgroundBulky appearance is a major shortcoming after surface coverage using free muscle flaps. The one-stage thinning procedure at the time of transfer can improve the appearance and avoid additional debulking surgery. We present our experiences in the reconstruction of complex lower extremity defects using thinned free muscle flaps.MethodsLatissimus dorsi muscle flaps (LDMs) and rectus abdominis muscle flaps (RAMs), which have vessel pedicles running deep in the muscles, were raised and the superficial tissue layers were removed to thin the flaps. These thinned muscle flaps were then used to resurface the wounds on lower extremities followed by coverage of skin autografts on the muscle surfaces.ResultsFourteen LDMs and four RAMs were thinned used for resurfacing eight, five, and three defects on feet, ankles, and pretibial regions, respectively, with wounds that ranged from 6 × 4 cm2to 23 × 9 cm2. All muscle flaps survived the tangential thinning procedures uneventfully. High take rates were observed for most skin grafts, except that a partial skin loss was found in one case. During the 1–20 months follow-up, the skin surface contours over the thinned muscle flaps matched well with adjacent areas.ConclusionsIntraoperative immediate thinning of LDMs and RAMs can be safely accomplished during the primary reconstruction procedure and may provide an alternative for coverage of complex lower extremity defects.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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DOI：
10.5999/aps.2014.41.6.693
发表时间：
2014-11
期刊：
Archives of plastic surgery
影响因子：
--
作者：
Prasetyono TO;Bangun K;Buchari FB;Rezkini P
通讯作者：
Rezkini P
影响因子：
2.1
作者：
M. Kauhanen;F. Lorenzetti;I. Leivo;E. Tukiainen;S. Asko-Seljavaara
通讯作者：
M. Kauhanen;F. Lorenzetti;I. Leivo;E. Tukiainen;S. Asko-Seljavaara
DOI：
10.1016/0007-1226(86)90084-6
发表时间：
1986-04
期刊：
British journal of plastic surgery
影响因子：
--
作者：
A. Rowsell;A. Godfrey;M. A. Richards
通讯作者：
A. Rowsell;A. Godfrey;M. A. Richards
影响因子：
3.6
作者：
Hui-Chou, Helen G.;Sulek, Jay;Rodriguez, Eduardo D.
通讯作者：
Rodriguez, Eduardo D.
DOI：
10.1016/0007-1226(89)90056-8
发表时间：
1989-09
期刊：
British journal of plastic surgery
影响因子：
--
作者：
J. Cassel
通讯作者：
J. Cassel