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題名 | Free Thoracodorsal Artery Chimeric Flap in Reconstruction of Massive Lower Limb Defects--A Case Report=以游離胸背動脈複合皮瓣重建大範圍下肢缺損--病例報告 |
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作者姓名(中文) | 姚全豐; 陳怡傑; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷期 | 22:1 2013.03[民102.03] |
頁次 | 頁41-46 |
分類號 | 416.413 |
關鍵詞 | 下肢缺損; 游離胸背動脈複合皮瓣; Chimeric; Thoracodorsal artery perforator flap; TAP flap; Latissimus dorsi muscle flap; LD muscle flap; |
語文 | 英文(English) |
中文摘要 | 背景:大範圍下肢缺損的重建一直是重建外科醫師的挑戰。重建上的困難在於所需重建的缺損是三度空間的立體結構往往需要游離皮瓣手術,而下肢外傷伴隨的血管損傷使游離皮瓣重建手術的難度提高。目的及目標:胸背動脈穿通枝及闊背肌皮瓣的複合式游離皮瓣適合用於重建大範圍下肢缺損。材料及方法:我們提出一名右側脛腓骨開放性骨折的59歲女性,以游離性胸背動脈複合皮瓣重建她右小腿及右足的軟組織缺損。結果:術後皮瓣成功存活,於術後3個月移除右下肢外固定器,術後4個月可行走。結論:游離胸背動脈複合皮瓣是利用穿通枝皮瓣及組織分離觀念從傳統的擴背肌皮瓣發展而來,可用於重建大範圍軟組織缺損而不增加皮瓣供區的損害。 |
英文摘要 | Background:Reconstruction of massive lower limb defects following trauma is a challenge for reconstructive surgeons. This challenge is presented by the large size of the defect requiring contoured free flap reconstruction and the possibility of trauma to the recipient vessels.Aim and Objectives:Free chimeric thoracodorsal artery perforator (TAP) -latissimus dorsi (LD) muscle flap is a good option for extensive lower extremity defect reconstruction.Materials and Methods:We reported a 59-year-old female patient with right distal tibia/fibula open fracture (Gustilo type IIIb). The extensive soft tissue defect over right distal leg and foot was reconstructed with chimeric TAP-LD flap based on the thoracodorsal artery system, enabling cover of a large defect without increasing donor morbidity.Results:The entire chimeric flap survived completely. The external fixators were removed at 3 months postoperatively. The injured limb recovered functional with full weight-bearing at 4 months after operation.Conclusion:The chimeric LD-TAP flap is a versatile application of the conventional flap based on the perforator concept and the concept of component separation. It allows coverage of large wounds without increasing donor site morbidity. |
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