急诊游离髂骨骨皮瓣一期修复下肢骨皮肤缺损.docVIP

急诊游离髂骨骨皮瓣一期修复下肢骨皮肤缺损 郭大强 郭伟文 李展添 邹红平 刘伟鑫 ?(广州市黄埔区红十字会医院???创伤外科,?广州?510760) 【摘要】 目的 研究急诊利用游离髂骨骨皮瓣一期修复下肢骨皮肤缺损的优点和可行性，总结游离髂骨骨皮瓣供血一期修复下肢骨皮肤缺损的疗效。 方法 对于5例5人的下肢不同受伤原因，采用急诊游离髂骨骨皮瓣一期修复下肢骨皮肤缺损进行修复，损伤主要致使下肢部分骨质缺损，伴有皮肤不同程度的损伤，估计术后会出现皮肤坏死或清创后会留有创面，皮肤缺损面积约5cm×6cm~7cm×12cm。骨质缺损3cm-5 cm~4.5cm×5.5 cm,皮瓣面积6cm×9cm~7cm×14cm。.骨质切取面积3cm-6 cm~5cm×6 cm皮瓣供区全部直接缝合。术后观察疗效。 结果 移植骨皮瓣全部成活，术后伤口一期愈合。随访2-12个月（平均8个月），所有病例骨折均愈合，临床愈合时间6-8周，骨性愈合时间7-10个月。移植骨均未见吸收，未见骨不连及再骨折。移植皮瓣外形良好，二次修薄2例。皮瓣无色素沉着和增生性疤痕。下肢行走良好。供区一期愈合。 结论 急诊游离髂骨骨皮瓣修复下肢骨皮肤缺损，一期修复骨质和皮肤缺损，减少住院天数和减少病人住院费用，骨愈合快，获得精细的专科修复。 【关键词】 下肢骨皮肤缺损；损伤； 游离髂骨骨皮瓣；一期修复下肢；显微外科技术 Repairing?the?bone?skins?defect?on?legs?with?free?cutaneous?iliac?flap?in?emergency?treatment?in?the?first?period Guo Da-qing,?GUO Wei-wen?,?LI Zhan-tian?,et al (Departmentof ?Traumatic?Surgery,The?Red?Cross?Hospital?of?Huangpu?District,?Canton??510760,China) Abstract Objective Researching the advantages and feasibility of using the free cutaneous iliac flap to repair the defect on legs in emergency treatment in the first period, summarizing the effect of using the free cutaneous Iliac Flap to repair the cutaneous defect on leg in the first period. Method For 5 cases of 5 patients’ different reasons of leg injury, using the free cutaneous iliac Flap to repair the defect on legs in emergency treatment in the first period. The injury mainly cause partial bone defect on legs, with cutaneous injury in varied degree. It is estimated that cutaneous necrosis will happen after surgery and scar will be left after debridement. The area of cutaneous defect is about 5cm×6cm~7cm×12cm. Bone defect was about 3cm-5cm~4.5cm×5.5cm, and the area of cutaneous flap was about 6cm×9cm~7cm×14cm. bone cutting area was about 3cm-6 cm~5cm×6 cm, cutaneous graft was suture directly. Result Transplanted iliac Flap all survived, the wound healed in the first period after the surgery. Following up 2-12 months(8 months on average), fractures of all cases healed. Clinical healing time was 6-8 we