游离肌瓣移植修复大面积烧伤后期深度创面  

Repair of extensive deep burn wounds in late stage with free muscle flap

作　　者：郑朝[1] 胡大海[1] 朱雄翔[1] 王耀军[1] 韩夫[1] 李娜[1] 折涛[1] 杨晨[1] 

机构地区：[1]第四军医大学西京医院全军烧伤中心烧伤与皮肤外科,西安710032

出　　处：《中华烧伤杂志》2012年第5期341-343,共3页Chinese Journal of Burns

摘　　要：目的探讨大面积深度烧伤后期伴骨关节外露创面的修复方法。方法2009年1月-2011年5月，往笔抒单位收治的大面积深度烧伤患者中，有5例于治疗后期伴育孽个或多个骨关节外露，无法通过游离植皮或皮瓣修复。其中5例伴单个骨关肖外露，2例伴2处以上骨关节及肌腱外露，创面大小为8cm×5cm～21cm×8cm。先后进行游离肌瓣复合刃厚皮（头皮）移植7例次，其中腹随肌肌瓣游离移植4例次、背阔肌肌瓣游离移植3例次。结果所有游离肌瓣及植皮均成活良好，骨关节外露创面完全修复，术后1年随访部分患者，修复部位外观良好，无溃疡、关节炎、骨髓炎等表现，关节功能正常。结论游离肌瓣复合头皮移植，能够为深度组织外露且缺乏供瓣区的患者提供有效的创面修复方法。Objective To explore the means for the reeonstruetion of extensiwe deep burn wounds with exposure of hone and joint in late stage. Methods Among all the patients with extensive deep burn hospitalized between January 2009 and May 20ll, 5 patients presented wouuds with exposure of bone and joint in the late stage of treatment that could not be covered by free skin grafts or flaps. Two of the five pa- tients had more than 2 and the other 3 patients had only one such wound （s）. The wound size ranged from 8 cm ~ 5 cm to 21 cm ~ 8 cm. Wounds were repaired by transplantation of 7 free muscle flaps （including 4 free rectus abdominis flaps and 3 latissimus dursi flaps） combined with split-thickness skin grafts harvested from seaip. Results All the muscle flaps and skin grafts survived. Wounds with bone and joint exposure healed well. At one-year fullow-up of some patients, good appearance of repaired areas and normal function of joints were observed with no signs of ulceration, arthritis, or osteomyelitis. Conclusions Transplanta- tion of free muscle flaps combined with split-thickness skin grafts harvested from the scalp provides satisfac- tory reconstruction for wounds with deep tissue exposure in patients with a shortage of skin donor site.

关 键 词：烧伤 显微外科手术 创面修复 游离肌瓣 

分 类 号：R644[医药卫生—外科学]