Reconstruction of Extensive Soft-Tissue Defects with Concomitant Bone Defects in the Lower Extremity with the Latissimus Dorsi-Serratus Anterior-Rib Free Flap.

Autor:	Sia WT; Hand & Microsurgery Section, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore., Xu GG; Department of General Surgery, Khoo Teck Puat Hospital, Singapore., Puhaindran ME; Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore., Tan BK; Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore., Cheng MH; Hand & Microsurgery Section, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore., Chew WY; Hand & Microsurgery Section, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Jazyk:	angličtina
Zdroj:	Journal of reconstructive microsurgery [J Reconstr Microsurg] 2015 Jul; Vol. 31 (6), pp. 407-13. Date of Electronic Publication: 2015 Jun 02.
DOI:	10.1055/s-0035-1548741
Abstrakt:	Background: The combined latissimus dorsi-serratus anterior-rib (LD-SA-rib) free flap provides a large soft-tissue flap with a vascularized bone flap through a solitary vascular pedicle in a one-stage reconstruction. Methods: Seven LD-SA-rib free flaps were performed in seven patients to reconstruct concomitant bone and extensive soft-tissue defects in the lower extremity (tibia, five; femur, one; foot, one). The patients were all male, with an average age of 34 years (range, 20-48 years). These defects were secondary to trauma in five patients and posttraumatic osteomyelitis in two patients. Results: All flaps survived and achieved bony union. The average time to bony union was 9.4 months. Bone hypertrophy of at least 20% occurred in all flaps. All patients achieved full weight-bearing ambulation without aid at an average duration of 23.7 months. Two patients developed stress fractures of the rib flap. There was no significant donor site morbidity, except for two patients who had pleural tears during harvesting of the flap. Conclusion: The LD-SA-rib flap provides a large soft-tissue component and a vascularized bone flap for reconstruction of composite large soft-tissue defects with concomitant bone defects of the lower extremity in a one-stage procedure. (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
Databáze:	MEDLINE
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