【摘要】 目的探讨大小腿联合皮瓣修复膝部及周围组织烧创伤等深度创面的临床治疗效果。方法选取2001年1月至2009年6月膝部及周围组织深度烧创伤患者28例,应用局部筋膜皮瓣、轴型皮瓣、肌皮瓣、岛状皮瓣修复创面,观察重要神经、血管、肌腱等组织的覆盖情况,皮瓣术后的成活情况,肢体的外型及功能。结果 19例一次手术修复创面愈合,皮瓣完全成活,术后随访功能恢复良好,3例创面清创后二期修复创面愈合,6例有部分皮瓣坏死,其中4例功能部分恢复,2例功能欠满意。结论大小腿联合皮瓣修复膝部及周围组织烧创伤深度创面能满足大部分创面的覆盖需要及复杂创面修复,修复后大部分功能恢复良好。术中应依据创面情况和位置,争取一期修复创面,首选局部皮瓣、轴型皮瓣、肌皮瓣和岛状皮瓣,局部无条件时选用游离皮瓣。更多还原

【Abstract】 Objective To investigate the choices and the clinical efficacy in the reparation of knee joint and surrounding tissue with the thigh and calf combined flaps in patients with severe trauma or burn injury.Methods From January 2001 to June 2009,local flaps,axial pattern shin flaps,muscle flaps, island flaps,and skin grafts were used to repair 28 patients of knee jointand surrounding tissue deep burn and trauma wounds.Then the coverage of the important nerves,blood vessels,tendons,the survival of skin flaps,physical appearance and functions of the limbs were observed.Results Nineteen patients with a surgical repair wound were healed at one-time.Flaps survived completely and knee joints obtained satisfactory functions.Three cases were cured by wound debridement at the secondstage.There were 6 cases of partial flap necrosis,including 4 cases of partial restoration of function,and 2 cases a bit weak.Conclusions The thigh and calf combined flaps for repairing deep burn or trauma wounds of knee joint and surrounding tissue can satisfy most of the wound coverage and complex wound repairing.The majority of functional recovery can still be satisfactory.Based on wound size and surrounding tissues conditions,local flaps,axial pattern shin flaps,muscle flaps,or island flaps should be prefered in operation,otherwise free flaps be chosen.更多还原