Pedicled Vastus Lateralis Muscle Flap with Perforator-Based Anterolateral Thigh Skin for Intractable Hip Infection

頑固性髖部感染對於骨科及整形外科醫師一直都是個困難的議題，我們報告一個老年病患因為攝護腺癌合併右側臗臼骨頭轉移而接受放射線治療，但是之後發生了右側髖臼病理性骨折，骨科醫師為他進行全髖關節置換術，遺憾的是術後傷口培養出金黃色葡萄球菌，且有持續性的分泌物從髖部傷口流出，在接受了兩年的抗生素及清創治療之後，情況仍持續著，因此進行了髖關節切除術並移除植入物，隨後留下了一個皮膚缺損15x8公分且伴隨深部空腔及股骨外露的問題性傷口，我們利用了根蒂股外側肌瓣合併以穿透枝為基礎之大腿前外側皮瓣重建了這個傷口，不僅利用股外側肌瓣填塞了深部空腔，也提供了大腿前外側皮瓣將傷口徹底覆蓋，此一頑固性的髖部感染終究獲得控制，傷口也順利癒合。

關鍵字

無資料

並列摘要

Intractable hip wound infection is difficult for both orthopaedic and plastic surgeons. Regional irradiation as a palliative therapy was given to an elderly patient suffering from right acetabulum bony metastasis of prostate cancer. Unfortunately, the patient then had a pathological fracture of the right acetabulum. An orthopaedic surgeon did a total hip arthroplasty, but the patient developed a persistent hip wound discharge that tested positive for Staphylococcus aureus. The patient was treated with parenteral antibiotics and several debridements. The condition persisted for almost 2 years, at which time resection arthroplasty with prosthesis removal was done. The resultant problem wound included a 15×8-cm skin defect, a deep cavity, and the exposed femoral bone. We reconstructed the defect by using the pedicled vastus lateralis muscle flap carrying a perforator-based anterolateral thigh skin paddle for simultaneous obliteration of dead space and soft tissue coverage. The intractable infected hip wound healed, and the infection was eventually controlled.

並列關鍵字

anterolateral thigh flap ； vastus lateralis flap ； intractable hip infection

國際替代計量

Pedicled Vastus Lateralis Muscle Flap with Perforator-Based Anterolateral Thigh Skin for Intractable Hip Infection

全文下載

主題瀏覽