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相關文獻
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| 題 名 | Free Flap Reconstruction for Scalp Defects with Infections=感染性頭皮缺損與自由皮瓣重建 |
|---|---|
| 作 者 | 黃馨慧; 林聿山; 黃國峰; 邱浩遠; 陳俊嘉; | 書刊名 | 臺灣整形外科醫學會雜誌 |
| 卷 期 | 25:4 2016.12[民105.12] |
| 頁 次 | 頁296-305 |
| 分類號 | 416.413 |
| 關鍵詞 | 頭皮重建; 自由皮瓣重建; 淺顳動靜脈; 慢性傷口; 感染性傷口; Scalp reconstruction; Free flap reconstruction; Superior temporal artery; Chronic wound; Wounds with infection; |
| 語 文 | 英文(English) |
| 中文摘要 | 背 景:複雜性頭皮傷口兼顧功能性和美觀性的重建一直是個挑戰。我們發現越來越多的頭皮慢性傷口因反覆感染而需要自由皮瓣重建。宗 旨:有些作者曾提出頭皮重建的流程,但是對複雜且反覆感染的傷口卻不盡適用。我們想分享我們對感染性頭皮傷口重建的經驗及文獻整理。材料及方法:回溯分析2008 年1 月到2016 年1 月在奇美醫院的案例,其中有10 個案例為使用自由皮瓣重建的感染性頭皮傷口。就傷口的成因,感染菌種、缺損的區域和大小、使用的皮瓣種類、供應血管和結果做分析和文獻蒐集。結 果:病人平均接受4.1 次頭部手術、6 成有植入物、4 成接受過放射治療。感染性頭皮重建的傷口缺損平均為57.7 平方公分。最常使用的是前臂皮瓣和前側大腿皮瓣。有91%的病人使用淺顳動靜脈作為接受血管。併發症的比率約27.3%(皮瓣壞死,癒合不良和感染)。結 論:感染性的頭皮傷口,重建常需要自由皮瓣來提供較好的血液循環,缺損面積大小並非決定因素。有外來植入物的病人,50%合併有Coagulase-negative Staphylococcus 感染。我們的經驗使用前臂皮瓣或前側大腿皮瓣,以淺顳動靜脈作為接受血管,可以減少使用vein graft 的機率。 |
| 英文摘要 | Background: Complicated scalp wounds are a challenge in both functional and aesthetic reconstruction. We noticed an increase in the number of chronic scalp wounds with infections that require free flap reconstruction. Aim and objectives: There are some algorithms for scalp reconstruction that have been proposed. However, many are difficult to apply to complicated defects with infections. We would like to share our experience and a review of the literature. Materials and methods: Retrospective data analysis of patients with reconstruction of scalp wounds between January 2008 and January 2016 in Chi-Mei medical center was performed. Ten patients with 11 free flaps reconstruction were selected. The etiology, microbiological data, types of free flap, region of defects, recipient vessels, and outcome were recorded. Results: Our patients have often been through repeated surgeries (mean 4.1 times /person), foreign body implantation (60%), and radiotherapy (40%). The mean extent of the scalp defects was 57.7 cm^2. The flaps used most often were free radial forearm flaps and anterolateral thigh flaps. Superior temporal artery and vein were used in 91% of cases as recipient vessels. Our complication rate was 27.3%, including one flap failure, one wound dehiscence, and one residual infection. Conclusion: Complicated scalp defects with infections often require free flap reconstruction. 50% of the patients with biosynthetic material suffered from Coagulase-negative Staphylococcus (CoNS) infection. Use of the superior temporal artery and vein as recipient vessels reduces the need of vein graft. |
本系統中英文摘要資訊取自各篇刊載內容。