유리피판술을 이용한 오랫동안 지속되는 만성창상의 치료

초록

Treatment with free flap in cases of longstanding non-healing exposured tennon and bone Aim: In cases of long-standing non-healing of tendon and bone exposure, we tried to evaluate the result and complications of the free flap reconstruction by analyzing flap success, wound healing time, and complications. Method: The retrospective study was that underwent from 2012 to 2023. 15 patients who had 16 flap reconstructions due to chronic tendon and bone exposure in upper and lower extremity were collected. Data were collected with patient information and cause of chronic wound. We have analyzed the result of flap success, wound healing time, complication of recipient wound, additional procedure, and donor complication. Results: There were 15 patients of mean age 57.1 years. Patient had 10 chronic disease such as, hypertension, diabetis, and artherosclerosis. The cause of the wound defect were 8 cases with trauma, 2 cases with complication of repetive surgery of lower extremity, and 5 cases with burn. There was exposured 10 cases with tendon exposure and 6 cases with bone exposure. All case had history of infection and inflammation after traum and initial surgery. The chronic wound were exposured tendon treated with negative pressure wound therapy and conservative with traditional foam dressing during 16 weeks at least. The period of wound dressing was 9 months.The mean size of wound were 24 cm 2. The type of the reconstruction flap flap were 2 Latissimus dorsi musculocutaneous flaps, 5 lateral arm free flaps(LAFF) and 8 anterolateral thigh free flaps(ALTFF)) and 1 fibular osteocutaneous free flap. The mean size of free flaps were 36 cm 2. all free flap were survived. The mean healing time of the chronic wound with free flaps were 9.5 weeks. The delayed wound healing were from tenosynovitis with continous serous drain. There was no active infection after free flap. The additional procedure such as secondary closure, skin graft, and local flap was 13 proced