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題名 | Reverse-Flow Anterolateral Thigh Flap in Reconstruction of Radiation-related Wound Dehiscence in the Upper Leg--Case Report=反向流動大腿前外側皮瓣在放射線治療引起小腿傷口癒合不全的重建--個案報告 |
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作者 | 黃宗君; 施秉庚; 陳信翰; 劉家瑋; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷期 | 23:1 2014.03[民103.03] |
頁次 | 頁55-60 |
分類號 | 416.413 |
關鍵詞 | 小腿傷口重建; 反向流動大腿前外側皮瓣; Reverse-flow anterolateral thigh flap; Distally based anterolateral thigh flap; |
語文 | 英文(English) |
中文摘要 | 背景:重建膝蓋周圍軟組織及骨頭曝露的缺損是種挑戰,特別是因為反覆手術及放射線治療後的傷口,因為其有好的外觀及可以早期活動膝關節,愈來愈多利用反向流動大腿前外側皮瓣重建小腿傷口。在這篇文章中,我們報告在使用反向流動大腿前外側皮瓣在重建小腿軟組織和骨頭曝露傷口重建的經驗。目的及目標:我們想要分享我們在因反覆手術和放射線治療造成挑戰性傷口重建上的經驗,臨床症狀、手術方式、影像、文獻回顧將在文章中描述。材料與方法:我們報告一個七十歲女性,因為反覆手術及放射線治療治療左小腿脂肪肉瘤造成的骨頭曝露。反向流動大腿前外側皮瓣被使用來重建此缺損。一個筋膜皮瓣10.5 × 6.0公分的皮瓣被取下,反向流動血管的通透性在取下前藉由鉗合近端供應血管得到確定。結果:此皮瓣初期有淤積的現象但最後存活,術後病程沒有感染也沒有膝蓋活動度的限制,兩年後也得到一個可接受的外觀。結論:重建因為反覆放射線治療和廣泛性切除造成的缺損,反向流動大腿前外側皮瓣可作為替代的選擇。 |
英文摘要 | Background:It is a challenge to reconstruct soft tissue and bony exposure defects around the knee, especially when caused by repeated operations and post-radiation injury. More and more applications of reverse-flow anterolateral thigh (rALT) flap to cover the defect of the upper-third leg have been reported based on its advantages of good contour and early mobilization of knee joint. In this article, we report our experience using rALT flap to reconstruct soft tissue defect and bone exposure of the upper-third leg.Aim and Objectives:We wished to share our experience in reconstructing a challenging wound defect that had been exposed to multiple operations and radiation damage. The clinical, and surgical procedure, and images are described and the literature is reviewed.Materials and Methods:We report a case of a 70-year-old female with bone exposure at the upper third of the left leg due to repeated operations and radiation treatments for liposarcoma. The rALT flap was used to repair the defect. A fasciocutaneous flap measuring 10.5 × 6.0 cm was harvested. Prior to take down, the patency of the reversed flow of the pedicle was confirmed by clamping the proximal end of the pedicle.Results:The flap survived despite initial congestion. The postoperative course was uneventful without infection and there was no limitation of range of motion of knee joint. An acceptable esthetic contour was recorded after 2 years.Conclusion:To reconstruct a defect for the upper third of the leg with prior repeated radiotherapy and multiple wide excisions, rALT flap could be one alternative choice. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。