Summary and discussion of repair of acute destructive wounds in the lower limbs using damage control orthopedics theory combined with anterolateral femoral perforator flap
10.3760/cma.j.cn431274-20240925-01467
- VernacularTitle:基于骨科损伤控制理论联合股前外侧穿支皮瓣修复急性下肢毁损性创面的临床效果
- Author:
Shenghu DU
1
;
Xueye DONG
;
Jian WANG
;
Huaibao ZHANG
;
Peifeng LI
;
Dexiao XU
;
Lin ZHANG
;
Ke TAO
Author Information
1. 温州医科大学附属第一医院创面修复科，温州 325000
- Publication Type:Journal Article
- Keywords:
Perforator flap;
Damage control;
Destruction damage;
Wound repair
- From:
Journal of Chinese Physician
2025;27(3):367-372
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize and discuss the clinical effect of different forms of anterolateral femoral perforator flap in the repair of acute lower extremity lesions based on the theory of damage control orthopaedics (DCO).Methods:The clinical data of 33 patients with acute destructive wounds in the lower limbs admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2022 were retrospectively analyzed. Under the guidance of the DCO theory, the combined injuries were treated through multidisciplinary consultation, and at the same time, first-stage debridement, bone stent restoration, limb blood transport reconstruction, nerve tendon repair and temporary vacuum sealing drainage (VSD) dressing were applied. After the systemic condition was stabilized, the wound was repaired with anterolateral femoral perforator flaps of different forms. The defect area was 8.0 cm×5.0 cm-35.0 cm×25.0 cm, and the donor flap area was closed in one stage in all cases.Results:30 cases of skin flap survived completely after operation, 2 cases had distal partial necrosis, wound healing after dressing change, 1 case had delayed complete necrosis. The follow-up time was 9-25(14.7±5.3)months. 2 patients were treated with the second stage of repair surgery due to the bloated flap. The rest were satisfied with the shape of the reconstructed flap and the donor flap area, and the ankle joint function score was good.Conclusions:DCO theory combined with anterolateral femoral perforator flap is a safe and effective way to repair the mutilated wounds of lower limbs.
