发生率和二次手术和截肢的危险因素在下肢救后
Ciara Brown1, Makenna Ash2, Ambika Menon1
1From the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA.
Annals of plastic surgery
|October 30, 2024
概括
自由组织转移 (FTT) 对于下肢肢体的挽救至关重要,但大多数患者需要进一步的手术. 咨询患者关于二次手术的高概率和截肢风险因素对于管理期望至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 重建性手术是一种重建性手术.
- 创伤外科 手术 创伤外科
背景情况:
- 下肢 (LE) 创伤缺陷往往需要自由组织转移 (FTT) 来进行重建.
- 虽然FTT的成功记录在案,但对二次手术或截肢后肢体救援的数据有限.
研究的目的:
- 评估LE肢体救援中FTT后二次手术的发生率和指示.
- 确定与二次手术和截肢相关的风险因素.
主要方法:
- 在一级创伤中心从2014年至2022年期间,对92 LE的自由进行了回顾性审查.
- 主要结局:FTT后的二次手术的发生率和指示.
主要成果:
- 72%的患者需要进行二次手术,平均每次救援7次手术.
- 10%的患者进行了截肢.
- 诸如BMI>30,脆弱性,型和Masquelet技术等因素与截肢相关;年龄较大和需要骨重建与二次手术相关.
结论:
- FTT对于挽救四肢至关重要,但患者必须被告知需要多次手术的可能性很高.
- 鉴定的风险因素可以预测截肢的可能性,强调需要进行彻底的手术前咨询,以使患者的期望与结果保持一致.
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