- 期刊
Pedicled Deep Inferior Epigastric Perforator (DIEP) Flap for Above Knee Amputation Stump Revision-＂Case Report＂
用局部深下腹穿通枝皮瓣改善下肢截肢後的殘肢外觀－病例報告
摘要
背景：在下肢截肢後常常出現一些併發症，包含傷口感染，缺血，或是傷口癒合不良而裂開，神經瘤，壓瘡，以及幻肢疼痛等。目的及目標：為了解決困擾病人殘肢的壓瘡，我們除了清創以外，更找尋適當的皮瓣來覆蓋傷口。材料及方法：基於較少的供應部位併發症和可以擁有大量的軟組織，我們選擇了局部深下腹穿通枝皮瓣來做殘肢傷口的重建。結果：經過局部深下腹穿通枝皮瓣來做殘肢傷口的重建，此報告提出了一位39歲因外傷而截肢的患者可以舒適的穿戴義肢。結論：局部深下腹穿通枝皮瓣重建殘肢傷口，不需要顯微重建的技術，較少的供應部位併發症，較低產生術後疝氣的問題，能夠在同一次手術完成重建，有較長且較大的血管可供使用，和較多的軟組織來重建缺損部位。
關鍵字
無資料並列摘要
Background: There were some complications after limb amputation, including stump wound infection, ischemia, even breakdown, stump neuromas, pressure ulcer, phantom limb pain. Aim and Objectives: With less donor site morbidity and a large volume soft-tissue, the deep inferior epigastric perforator (DIEP) flap is mainly used for reconstruction as a free flap. It is also useful as a pedicled flap, however, it has seldom been described for reconstruction of an amputation stump. If wound closure of above-knee amputation is to involve split-thickness skin grafting, the graft is possible to ulcerate as soon as use of prosthesis is begun. Although this can often be treated by local socket relief, surgical revision may be required. Materials and Methods: This 39 year-old male with a history of left above knee amputation due to trauma presented with an unstable pressure ulcer on the amputation stump. Of this, he was indicated for flap reconstruction. Finally, he was satisfied with this good outcome. Results: After reconstruction, the patient subsequently underwent fitting for a new prosthesis and able to resume ambulation at 4 months post-operatively. Conclusion: There are several advantages in pedicled DIEP flap: (1) no need for microsurgical technique (2) less donor site morbidity with primary closure (3) low ventral hernia rate (4) one-stage procedure (5) longer, larger diameter, and robust pedicle (6) large available tissues for defect.
延伸閱讀
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