用下肢毁损性创面患者截肢后废弃肢体制成的组织瓣的临床应用效果  

Clinical application effects of tissue flaps prepared from the discarded limbs after amputation in patients with destructive wounds in the lower limbs

作　　者：黄覛韬 何志友 张丕红[1] 张明华[1] 崔旭[1] 郭乐 黄晓元[1] 梁鹏飞[1] Huang Mitao;He Zhiyou;Zhang Pihong;Zhang Minghua;Cui Xu;Guo Le;Huang Xiaoyuan;Liang Pengfei(Department of Burns and Plastic Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院烧伤整形外科,长沙410008

出　　处：《中华烧伤与创面修复杂志》2025年第1期77-83,共7页Chinese Journal of Burns And Wounds

基　　金：湖南省自然科学青年基金项目(2022JJ40791)。

摘　　要：目的探讨用下肢毁损性创面患者截肢后废弃肢体制成的组织瓣的临床应用效果。方法该研究为回顾性观察性研究。2019年3月—2024年3月,中南大学湘雅医院烧伤整形外科收治7例符合入选标准的下肢毁损性创面男性患者,年龄35~57岁。毁损肢体经临床处理后仍难以保肢,采用截肢后废弃肢体制成的组织瓣带蒂移植修复下肢毁损性创面者5例,其中创面面积为15 cm×10 cm~25 cm×15 cm,组织瓣切取面积为15 cm×10 cm~20 cm×15 cm;采用截肢后废弃肢体制成的组织瓣游离移植修复下肢毁损性创面者2例,其中创面面积为22 cm×18 cm、25 cm×15 cm,组织瓣切取面积为23 cm×20 cm、25 cm×18 cm。随访观察组织瓣存活情况、受区创面愈合情况和外观。末次随访时,采用皮瓣综合评价量表评定受区恢复情况,并记录佩戴矫正假肢情况。结果随访6~24个月,组织瓣均存活,受区创面愈合较佳且外观良好。末次随访时,受区恢复情况评分为36~39分(平均37.2分),截肢肢体均可佩戴矫正假肢且远端无破溃。结论利用下肢毁损性创面患者截肢后废弃肢体制成的组织瓣修复创面有效利用了废弃组织,避免产生新的供区,是修复多处毁损性创面的一种可供考虑的方法。Objective To explore the clinical application effects of tissue flaps prepared from the discarded limbs after amputation in patients with destructive wounds in the lower limbs.MethodsThe study was a retrospective observational study.From March 2019 to March 2024,7 male patients with destructive wounds in the lower limbs who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of Xiangya Hospital of Central South University,aged 35 to 57 years.After clinical treatment,the damaged limbs were still difficult to preserve.Five patients with destructive wounds in the lower limbs were repaired with pedicled tissue flaps prepared from the discarded limbs after amputation,with wound areas of 15 cm×10 cm to 25 cm×15 cm and tissue flap incision areas of 15 cm×10 cm to 20 cm×15 cm.Two patients with destructive wounds in the lower limbs were repaired with free tissue flaps prepared from the discarded limbs after amputation,with wound areas of 22 cm×18 cm and 25 cm×15 cm and tissue flap incision areas of 23 cm×20 cm and 25 cm×18 cm.The survival of the tissue flap,the healing and appearance of wounds in the recipient site were followed up.At the last follow-up,the recovery status of the recipient site was evaluated according to the comprehensive flap evaluation scale,and the status of corrective prosthesis fitting was recorded.ResultsDuring the follow-up of 6 to 24 months,all the tissue flaps successfully survived,with good healing and appearance of wounds in the recipient site.At the last follow-up,the scores of the recovery status of the recipient site ranged from 36 to 39(with an average of 37.2).All amputated limbs were able to accommodate corrective prostheses with no distal ulceration.ConclusionsUtilizing tissue flaps prepared from the discarded limbs after amputation in patients with destructive wounds in the lower limbs to repair wounds effectively uses the discarded tissue and avoid creating new donor sites,which is a method to be considered for repairing multiple destructive

关 键 词：烧伤 四肢 外科皮瓣 截肢术 下肢毁损伤 废弃肢体 创面修复 

分 类 号：R47[医药卫生—护理学]