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題 名 | Modified Politeo-Posterior Thigh Flap for Chronic Ulcer of the Knee-Case Reports=改良型膕部支脈後股皮瓣做膝部慢性潰瘍的覆蓋--二病例報告 |
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作 者 | 葉俊廷; 陳恆信; 魏福全; 陳宏基; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 31:2 民87.03-04 |
頁 次 | 頁129-133 |
分類號 | 416.413 |
關鍵詞 | 皮瓣; 膝部; 慢性潰瘍; Knee ulcer; Island pedicle flap; Modified popliteo-posterior thigh flap; Reverse flow fasciocutaneous flap; |
語 文 | 英文(English) |
中文摘要 | 膝蓋部部位是軟組織缺損是一件很棘手的問題,尤其是膝蓋附近的組織,往往也 同時受傷。我們報告兩例膝蓋上面的傷口,以改良型膕部支脈後股皮瓣做膝部慢性潰瘍的覆 蓋。此皮瓣是基於膕部上行支脈,其分布於膕部且介於股雙頭肌和半腱肌上行至大腿後側。 我們的改良是保留皮瓣根部的真皮及皮下組織,藉以增加皮瓣的靜脈迴流和血液循環。第一 例為多次膝部外傷引起的傷口不癒,第二例為膝關節置換後引起的慢性骨髓個皮瓣癒合狀況 良好,供皮瓣區的補皮狀況好。此皮瓣提供膝蓋部位組織缺損良好的方式,且保留了周遭肌 肉的功能、把傷口隱藏後側,減少外觀上的問題。這不一定是最法,但它很簡單而且不會失 敗,是另一種重式。同時我們也探討其他肌皮瓣在膝部重建缺點。 |
英文摘要 | Soft tissue defects over the knee joint can be a troublesome problem. The upper part of the anterior aspect of the knee is a particularly difficult area because the adjacent skin and muscles often have been damaged at the same time. Here, we present cases of two patients who with soft tissue defects over the knee, which were reconstructed with a modified popliteoposterior thigh flap. The flap was based on a per forator from the popliteal artery, which lay in the upper part of the popliteal fossa and ascended in the midline between semitendinosus and biceps femolis. The flap was augmented with the dermis around the vascular pedicle, and was transposed distally to cover the defect. The preserved dermis pedicle could increase venous drainage, thus promoting circulation in the flap. This improvement might come from microvenous interconnections between the venae comitantes and venules in the subcutaneous tissue and it could prevent venous congestion, which would have occurred because of flow prevent venous congestion, which would have occurred because of flow characteristics of the reverse flap. One case suffered from repeated trauma over the knee and the other had chronic osteomyelitis following total knee replacement with resultant infection. The flap survived well and the donor site wound healed by skin graft. This flap survived well and the donor site wound healed by skin graft. This flap is a easy method for reconstruction of chronic wounds around the knee. It preserves surrounding muscle function because it does not sacrifice muscle function, as does a musculocutaneous flap. In addition, the donor site wound is hidden on the posterior thigh and is less conspicuous. There is also discussion of myocutaneous flaps and fasciocutaneous flaps for knee reconstruction. |
本系統中英文摘要資訊取自各篇刊載內容。