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全膝关节置换术后皮肤坏死的处理 被引量:6

Management of skin necrosis after total knee arthroplasty
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摘要 目的探讨应用真空负压引流术(VSD)、内侧腓肠肌皮瓣转移术治疗全膝关节置换(TKA)术后皮肤坏死,挽救TKA的疗效。方法 2007年至2009年本组共有4例患者采用内侧腓肠肌皮瓣转移术治疗TKA术后伤口皮肤坏死,平均随访19个月(12~32个月),采用KSS膝关节评分系统进行功能评价,在最后随访时对患者的感染消除情况进行临床评价,测量患者活动度。结果根据KSS膝关节评分系统,4例患者结果优良。所有患者均有良好的股四头肌力量。患者不需要助步器行走,所有皮瓣一期愈合,无感染复发。结论内侧腓肠肌皮瓣能提供良好的覆盖,允许早期活动和快速康复,可以降低TKA术失败后关节僵硬的发生率。 Objective To investigate the effect of vaccum sealing drainage (VSD) and medial gastrocnemius graft on skin necrosis after total knee arthroplasty. Methods Four patients were treated with medial gastrocnemius muscle flap transfer after TKA for wound problems between 2007 and 2009. The average follow-up time was 19 months (range 12 -32 months). Functional evaluation was performed by the KSS knee rating scale. The patients were evaluated clinically for resolution of infection at final follow-up. Range of motion was measured with a goniometer. Results Four patients had excellent or good outcomes according to the KSS knee rating scale. All patients had good or excellent quadriceps strength. No patient required a walking aid for community ambulation. All patients had resolution of infection. All flaps healed primarily with no recurrence of infection. Conclusions The medial gastrocnemius muscle flap provides good quality coverage, permits early mobilization and fast rehabilitation, and reduces the rate of joint stiffness after failure of total knee arthroplasty.
出处 《中华关节外科杂志(电子版)》 CAS 2012年第6期9-11,共3页 Chinese Journal of Joint Surgery(Electronic Edition)
基金 国家自然科学基金面上项目(81171738)
关键词 关节成形术 置换 腓肠肌 坏死 Arthroplasty, replacement, knee Gastrocnemius Necrosis
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参考文献13

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同被引文献45

  • 1屈燕铭,袁杰,王力刚,李浩喻,温贺龙,黄仁辉.封闭负压引流技术在治疗严重皮肤软组织缺损中的应用[J].中华临床医师杂志(电子版),2011,5(22):6805-6806. 被引量:7
  • 2Vince KG, Abdeen A. Wound problems in total knee arthroplasty. Clin Orthop Relat Res, 2006, (452): 88-90.
  • 3Galat DD, McGovern SC, Larson DR, et al. Surgical treatment of early wound complications following primary total knee arthroplasty. J Bone Joint Surg (Am), 2009, 91(1): 48-54.
  • 4Panni AS, Vasso M, Cerciello S, et al. Wound complications in total knee arthroplasty. Which flap is to be used? With or without retention of pros- thesis? Knee Surg Sports Traumatol Arthrosc, 2011, 19(7): 1060-1068.
  • 5Ries MD. Skin necrosis after total knee arthroplasty. 1 Arthroplasty, 2002, 17(4 Suppl 1): 74-77.
  • 6Ries MD, Bozic K. Medial gastrocnemius flap coverage for treatment of skin necrosis after total knee arthroplasty. Clin Orthop Relat Res, 2006, 446(2): 186-192.
  • 7Vince K, Chivas FD, Droll KP. Wound complications after total knee arthroplasty. I Arthroplasty, 2007, 22 (4 Suppl 1): 39-44.
  • 8Andres LA, Casey WJ, Clarke HD. Techniques in soft tissue coverage around the knee. Tech Knee Surg, 2009, 8(2): 119-125.
  • 9Casanova D, Hulard O, Zalta R, et al. Management of wounds of ex- posed or infected knee prostheses. Scand I Plast Reconstr Surg Hand Surg, 2001, 35(1): 71-77.
  • 10Busfield BT, Huffman GR, Nahai F, et al. Extended medial gastrocne- mius rotational flap for treatment of chronic knee extensor mechanism deficiency in patients with and without total knee arthroplasty. Clin Orthop Relat Res, 2004, (428): 190-197.

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