坏死性筋膜炎腋窝缺损重建及游离皮瓣清创术:附3例报告

Haruo Ogawa, Haruki Nakayama, S. Nakayama, S. Tahara
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引用次数: 1

摘要

背景坏死性筋膜炎是一种众所周知的疾病,可引起广泛的组织感染,需要对感染组织进行彻底清创。它可以发生在身体的所有部位,但很少有关于腋窝坏死性筋膜炎的报道。我们治疗了3例腋窝坏死性筋膜炎。方法所有病例均在急诊科对感染软组织进行根治性清创后转诊。第一次到我科就诊时,腋窝有拳头大小的软组织缺损。此外,由于坏死性筋膜炎的清创,同侧胸大肌和背阔肌被部分切除。在所有病例中,同侧胸背侧血管严重受损,并进行自由皮瓣转移以关闭腋窝伤口。结果所有皮瓣均成活,无并发症。术后患者患侧肩关节外展的活动范围得以维持。结论腋窝发生坏死性筋膜炎,组织感染可向外扩散。在这种情况下,自由皮瓣转移是最佳的治疗方法。根治性切除感染组织导致腋窝内受体血管缺失。外科医生应该记住,由于感染组织的根治性切除,他们可能需要寻找远离腋窝的自由皮瓣移植的受体血管。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reconstruction of Axillary Defect due to Necrotizing Fasciitis and Debridement Using a Free-Flap Transfer: A Report of Three Cases
Abstract Background Necrotizing fasciitis is a well-known disease that causes extensive tissue infection and requires radical debridement of the infected tissue. It can occur in all parts of the body, but there are few reports of necrotizing fasciitis in the axilla. We treated three patients with axillary necrotizing fasciitis. Methods In all cases, patients were referred to us after radical debridement of the infected soft tissue in the emergency department. At the first visit to our department, there were fist-sized soft tissue defects in the axilla. Moreover, the ipsilateral pectoralis major and latissimus dorsi muscles were partially resected because of the debridement of necrotizing fasciitis. In all cases, the ipsilateral thoracodorsal vessels were severely damaged and free-flap transfer was performed to close the axillary wound. Results All free flaps survived without complications. The patient's range of motion for shoulder abduction on the affected side was maintained postoperatively. Conclusion If necrotizing fasciitis occurs in the axilla, tissue infection can spread beyond it. In such a case, free-flap transfer can be an optimal treatment. Radical resection of the infected tissue results in the absence of recipient vessels in the axilla. Surgeons should bear in mind that, because of radical resection of the infected tissue, they may need to seek recipient vessels for free-flap transfer far from the axilla.
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