An Extremely Long Pedicle for a Fillet Lower Leg Flap-A Case Report

極長血管莖的小腿菲力（fillet）皮瓣－病例報告

王彥博(Yan-Bo Wang) ； 張世幸(Shih-Hsin Chang) ； 黃文成(Wen-Chen Huang) ； 董光義(Kuang-Yi Tung)

《臺灣整形外科醫學會雜誌》 23卷4期 (2014/12) Pp. 356-361

摘要

背景：在半身癱瘓病人身上，復發壓瘡因為缺乏可用皮瓣，經常是個嚴苛的考驗。目的及目標：我們提出一個病例，以一段長的膕血管和股血管為血管莖的小腿菲力皮瓣，覆蓋大的骶骨褥瘡。材料及方法：一名37歲的半身癱瘓患者患有骶部及雙側粗隆潰瘍。因無法治癒的髖關節積膿而無法避免髖關節截斷術。在此情形下以膕血管和股血管軸為血管莖的小腿菲力皮瓣覆蓋骶骨潰瘍。結果：術後過程順利。該患者恢復之後能夠自由擺位和坐輪椅活動。結論：這個術式提供半癱病患較迅速的恢復以及早期復健，使之能夠早日達到獨立以及回復到日常生活。

並列摘要

Background: Recurrent pressure ulcers in an active paraplegic patient is challenging as the options available for simple flap are depleted. Aim and Objectives: We present the case of a patient in whom we isolated and raised a fillet lower leg flap on a long pedicle that included the popliteal and femoral vessels to cover a large sacral pressure ulcer. Case presentation: A 37-year-old paraplegic patient had been developing sacral and trochanteric ulcers on both the sides for many years. However, because of intractable and recurrent bilateral hip joint suppurative arthritis, hip disarticulation was unavoidable. A long pedicle flap from the hip-disarticulated left lower limb based on the femoral-popliteal axis was used to cover these sacral ulcers. Results: The postoperative course was uneventful. The patient could subsequently resume unrestricted sitting and wheelchair mobilization. Conclusion: The procedure was a quick solution for the patient, and the patient could begin early rehabilitation to achieve independence and could return to daily life activities.

並列關鍵字

Pressure Ulcer ； Surgical Flaps