원위기저비복피판에서 지연처치의 임상적 적용

Clinical Application of the Delayed Procedure in the Distally Based Sural Flap

  • 임형우 (을지대학교 의과대학 성형외과학교실) ;
  • 박용준 (을지대학교 의과대학 성형외과학교실)
  • Yim, Hyung-Woo (Department of Plastic and Reconstructive Surgery, College of Medicine, Eulji University Hospital) ;
  • Park, Yong-Joon (Department of Plastic and Reconstructive Surgery, College of Medicine, Eulji University Hospital)
  • 투고 : 2009.11.06
  • 심사 : 2010.04.16
  • 발행 : 2010.11.10

초록

Purpose: Reconstruction of soft tissue defects with osteomyelitis in the lower third of the leg represents a challenge to plastic surgeons. Moreover, it is more arduous in multimorbid patients. One excellent option for reconstruction of these defects is to use a delayed distally based sural flap. Methods: We successfully used delayed distally based sural flap with a two-step procedure. During the first operation, radical debridement and elevation of flap were performed. The raised flap was fixed again at the donor site. The delay period ranged from seven to ten days. Between August 2008 and July 2009, we underwent operations for five patients using this technique. The size of flap varied from $10{\times}6\;cm$ to $12{\times}14\;cm$. Results: All flaps successfully survived. Partial skin loss of the grafted site was seen in two patients but no further surgical procedure was required for wound healing. Complaints of hypoesthesia on the lateral part of the foot was observed. In a three month follow-up period, hypoesthesia was resolved spontaneously. Conclusion: Delayed procedure improves the viability of distally based sural flap in high risk, critically multimorbid patients. We recommend that, if a two-stage operative approach is required, the delayed procedure should be considered.

키워드

참고문헌

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