下たい難治性かいよう（皮膚欠損）の治療経験

Abstract

The leg consisted of a tight skin envelope directly covering bone and musculotendinous structures. Soft tissue defects in this area were difficult to repair because of the poor blood supply to the skin and the limitations imposed in designing reliable flaps. Several kinds of new reconstructive procedures for coverage of the leg were introduced.11 patients were treated with different flap transfers for soft tissue defects of the leg, between 1980 and 1983 at the Yamaguchi University School of Medicine.There were 5 free flaps, 4 pedicle skin flaps and 2 muscle flaps. All patients were male and their ages ranged between 20 and 65 year-old. Types of the free flaps used included free latissimus dorsi (2), free groin flap (2), and free peroneal flap (1), The pedicle flaps consisted dorsalis pedis flap (1), peroneal flap (1), bipedicle gastrocnemius M-C flap (1) and cross leg fasciocutaneous flap (1). The muscle flaps used the peroneus longs, brevis and the abductor hallucis (1), and the gastrocnemius (1). All flaps survived and any sequelae of the skin and tibia bone did not occur.The authors emphasized the superiority of the free latissimus dorsi, free peroneal flap, pedicle peroneal flap and cross leg fasciocut aneous flap for coverage of soft tissue defect of the leg.