FREE TISSUE TRANSPLANTATION FROM AMPUTATED LIMBS FOR COVERING RAW SURFACE OF STUMPS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Wengbo , WU Xiaoshu , YANG Dawei , JIANG Chunzhi.

Department of Hand Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing Jiangsu, 210006, P.R.China.;

Corresponding author：

Keywords：

Severe injury; Amputation; Free flap; Wound repair

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【Abstract】 Objective To investigate and evaluate the effectiveness of covering amputated raw surface with free
tissue transplantation from damaged limbs. Methods Between August 2010 and June 2011, 5 cases of severe injury of lower extremities were treated, including 4 males and 1 female with an age range of 3 years and 8 months to 43 years. Of them, 3 cases suffered from traffic accident injury and 2 had machine injury. The disease duration was 2-9 hours. Among the 5 cases, 1 suffered from half pelvis destruction and traumatic amputation of hip joint, 1 from comminuted open fracture of proximal femur, and another 3 from thigh destruction with survival soft tissue of legs. All cases were treated with emergency operation of amputation. The raw surface of the residual stumps was 20 cm × 10 cm to 20 cm × 20 cm in size. Two lateral anterior thigh flaps and 3 posterior tibial artery flaps were harvested from the damaged limbs. The flap size ranged from 15 cm × 10 cm to 25 cm × 20 cm. The wounds were repaired with free tissue transplantation. Results Five transplanted tissue flaps were survival. Skin necrosis occurred in the wound edge at 7-10 days postoperatively and was cured after excision of necrotic tissue, dressing change or vacuumed drainage for 1-2 months. All wounds healed and the patients were followed up 1-3 months. No sinus tract or ulceration was observed. The appearance of stumps was satisfactory. Conclusion The effectiveness of repairing amputated raw surface with free tissue transplantation from amputated limbs is satisfactory. It is an effective procedure to repair the raw surface of amputated stumps.

Citation： YANG Wengbo,WU Xiaoshu,YANG Dawei,JIANG Chunzhi.. FREE TISSUE TRANSPLANTATION FROM AMPUTATED LIMBS FOR COVERING RAW SURFACE OF STUMPS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(2): 215-218. doi: Copy

1.	周祥吉, 范启申, 王成琪. 82例下肢毁损伤濒临截肢的救治分析. 中华创伤杂志, 2001, 17(11): 661.
2.	夏宁晓, 马玉林, 岳思军. 显微外科方法治疗四肢严重毁损伤. 中华显微外科杂志, 2000, 23(2): 107-108.
3.	任鹏, 陈刚, 阿不来提• 阿不拉, 等. 封闭式负压引流技术在下肢毁损伤中的应用. 中国修复重建外科杂志, 2010, 24(8): 1021-1022.
4.	杨占辉, 王振普, 石明国, 等. 不同方式的小腿外侧皮瓣修复严重肢体组织缺损(23例报告). 中国骨与关节损伤杂志, 2006, 21(10): 794-796.
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6.	谭海涛, 林源, 江建中, 等. 游离股前外侧皮瓣与健侧血管桥接修复下肢严重毁损伤. 中华显微外科杂志, 2002, 25(1): 71-72.
7.	张丕红, 黄晓元, 龙剑虹. 肢体严重毁损伤保留与否的循证思考. 医学与哲学: 临床决策论坛版, 2006, 27(5): 50-51.
8.	陈睿, 宋恒平. 对3例下肢重度毁损伤的处理决策分析及处理体会. 中国矫形外科杂志, 2011, 19(6): 522-523.
9.	张功林, 葛宝丰, 荆浩. 从创伤性截肢切取游离皮瓣修复肢体残端. 中华整形外科杂志, 2001, 13(1): 46-47.
10.	闫红军. 游离皮瓣应用于创伤性截肢2例. 中国伤残医学, 2009, 17(2): 135-136.
11.	Frykman GK, Jobe CM. Amputation salvage with microvascular free flap from the amputated extremity. J Trauma, 1987, 27(3): 326-329.
12.	丰德宽, 李储忠, 肖鹏康. 残肢隐动脉交腿胫骨皮瓣修复胫骨及皮肤缺损一例. 中华显微外科杂志, 1998, 21(3): 235.
13.	叶祥柏, 陈忠勇. 电烧伤遗弃上肢巨大剔骨肌皮瓣游离移植一例. 中华整形外科杂志, 2002, 18(3): 190.
14.	张功林, 郭翱, 张灵芝, 等. 从创伤性离断肢体切取游离皮瓣修复前臂残端软组织缺损. 中华医学杂志, 2007, 87(27): 1912-1914.
15.	Ghali S, Harris PA, Khan U, et al. Leg length preservation with pedicled fillet or foot flaps after tramatic amputations. Plast Reconstr Surg, 2005, 115(2): 498-505.
16.	杨绍安, 靳安民, 曾参军, 等. 四肢大面积皮肤撕脱合并主要血管损伤的显微外科治疗. 中华显微外科杂志, 2005, 28(2): 183-184.

1. 周祥吉, 范启申, 王成琪. 82例下肢毁损伤濒临截肢的救治分析. 中华创伤杂志, 2001, 17(11): 661.
2. 夏宁晓, 马玉林, 岳思军. 显微外科方法治疗四肢严重毁损伤. 中华显微外科杂志, 2000, 23(2): 107-108.
3. 任鹏, 陈刚, 阿不来提• 阿不拉, 等. 封闭式负压引流技术在下肢毁损伤中的应用. 中国修复重建外科杂志, 2010, 24(8): 1021-1022.
4. 杨占辉, 王振普, 石明国, 等. 不同方式的小腿外侧皮瓣修复严重肢体组织缺损(23例报告). 中国骨与关节损伤杂志, 2006, 21(10): 794-796.
5. 苑芳昌, 杨晖, 韩崇伟. 股前外侧皮瓣治疗小腿严重毁损伤. 中华创伤骨科杂志, 2006, 8(11): 1090-1091.
6. 谭海涛, 林源, 江建中, 等. 游离股前外侧皮瓣与健侧血管桥接修复下肢严重毁损伤. 中华显微外科杂志, 2002, 25(1): 71-72.
7. 张丕红, 黄晓元, 龙剑虹. 肢体严重毁损伤保留与否的循证思考. 医学与哲学: 临床决策论坛版, 2006, 27(5): 50-51.
8. 陈睿, 宋恒平. 对3例下肢重度毁损伤的处理决策分析及处理体会. 中国矫形外科杂志, 2011, 19(6): 522-523.
9. 张功林, 葛宝丰, 荆浩. 从创伤性截肢切取游离皮瓣修复肢体残端. 中华整形外科杂志, 2001, 13(1): 46-47.
10. 闫红军. 游离皮瓣应用于创伤性截肢2例. 中国伤残医学, 2009, 17(2): 135-136.
11. Frykman GK, Jobe CM. Amputation salvage with microvascular free flap from the amputated extremity. J Trauma, 1987, 27(3): 326-329.
12. 丰德宽, 李储忠, 肖鹏康. 残肢隐动脉交腿胫骨皮瓣修复胫骨及皮肤缺损一例. 中华显微外科杂志, 1998, 21(3): 235.
13. 叶祥柏, 陈忠勇. 电烧伤遗弃上肢巨大剔骨肌皮瓣游离移植一例. 中华整形外科杂志, 2002, 18(3): 190.
14. 张功林, 郭翱, 张灵芝, 等. 从创伤性离断肢体切取游离皮瓣修复前臂残端软组织缺损. 中华医学杂志, 2007, 87(27): 1912-1914.
15. Ghali S, Harris PA, Khan U, et al. Leg length preservation with pedicled fillet or foot flaps after tramatic amputations. Plast Reconstr Surg, 2005, 115(2): 498-505.
16. 杨绍安, 靳安民, 曾参军, 等. 四肢大面积皮肤撕脱合并主要血管损伤的显微外科治疗. 中华显微外科杂志, 2005, 28(2): 183-184.

Chinese Journal of Reparative and Reconstructive Surgery

FREE TISSUE TRANSPLANTATION FROM AMPUTATED LIMBS FOR COVERING RAW SURFACE OF STUMPS

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