移植和皮瓣全景回顾

Adriana Elizabeth Iza Echeverría, Ana Patricia Guailacela Gómez, Tania Cristina Bernal Quizhpi, Marcelo Alexander Pico Aldas, Luis Miguel Cabrera Tenecela, Aldrin Santiago Cando Calle, Nathaly Mishell Naranjo Cevallos, Byron Fabián Pinos Reyes, Geovanna Karolina Cazorla Andrade, Bryam Esteban Coello García
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摘要

导言:随着时间的推移,植皮技术已发展成为多种成熟的重建技术,能够显著恢复各种手术创伤的结构、功能和美观。肌肉瓣和肌皮瓣是后天性肿瘤或外伤性缺损患者常用的重建替代方法。目的:详细介绍与移植物和皮瓣相关的最新信息;定义、描述、分类、特征、适应症和技术。方法:本综述共分析了 33 篇文章,包括综述性文章、原创性文章以及临床病例,其中有 20 篇参考文献,因为其他文章与本研究无关。信息来源于PubMed、Google Scholar和Cochrane;搜索西班牙文、葡萄牙文和英文信息时使用的术语为:皮瓣、移植物、皮肤、伤口、手术重建、皮肤移植。结果:皮肤移植是一项基本技术,也是外科手术、肿瘤切除术、溃疡以及烧伤患者广泛使用的重建方法。植皮回缩与植皮厚度成反比。移植物应在整体上与需要覆盖的损失物质相对应。在规划肌皮瓣时,了解每个源动脉或血管簇的血管区域,可以正确设计皮岛。与筋膜皮瓣不同,肌肉和肌皮瓣对缺血的耐受性很差,如果担心皮瓣缺血,就必须及时返回手术室进行探查:认识何时、何地以及如何进行移植或皮瓣手术,对于正确处理患者的病情至关重要。必须熟知手术的基本原理和相关因素,才能使患者获得最佳表现和最佳效果。移植物和皮瓣都有其适应症,必须根据患者的具体情况进行调整。有必要强调的是,必须完全区分移植物和皮瓣,分析它们的特殊性、不同用途和可能出现的并发症。移植物没有任何血管连接,而皮瓣则依赖于受体伤口床的血管化才能存活。关键字:皮瓣、移植物、皮肤、伤口、重建、转移、手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
GRAFTS AND FLAPS PANORAMIC REVIEW
Introduction: Skin grafts over time have progressed to present multiple well-established reconstructive techniques that are remarkably capable of restoring structure, function, and aesthetics to a myriad of surgical wounds. Muscle and myocutaneous flaps are common reconstructive alternatives for individuals with acquired oncologic or traumatic defects. Knowledge of flap anatomy and surgical techniques is paramount for surgeons who practice them to achieve the best results. Objective: to detail current information related to grafts and flaps; definition, description, classification, characteristics, indications and techniques. Methodology: a total of 33 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 20 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: flaps, grafts, skin, wounds, surgical reconstruction, skin transfers. Results: skin grafting is a basic technique and a widely used reconstruction option in surgery, following tumor resection, ulcers, as well as in burned individuals. Graft retraction is inversely proportional to graft thickness. The graft should globally correspond to the loss of substance to be covered. When planning myocutaneous flaps, knowing the vascular territories of each source artery, or angiosome, allows proper design of the skin island. Unlike fasciocutaneous flaps, muscle and myocutaneous flaps tolerate ischemia poorly, and any concerns about flap ischemia necessitate a timely return to the operating room for exploration. Conclusions: Recognizing when, where and how to perform a graft or flap is of vital importance for the correct management of the affected individual. The surgical fundamentals and associated factors must be well known to achieve the best performance and achieve the best results in patients. Both grafts and flaps have their indications that must be adapted to the patient in question. It is necessary to emphasize that it is necessary to differentiate perfectly between the graft and the flap, analyzing their peculiarities, different uses and possible complications. Grafts are devoid of any vascular connection, while flaps depend on the vascularization of the recipient wound bed to survive. KEY WORDS: flaps, grafts, skin, wounds, reconstruction, transfers, surgery.
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