transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2010-0-3-4-23-26transplantologiya-290Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSМикрохирургическая аутотрансплантация тканей в лечении открытых переломов конечностейMicrosurgical tissue autotransplantation in the treatment of open limb fracturesШибаевЕ. Ю.ShibayevE. Yu.ИвановП. А.IvanovP. A.КисельД. А.KiselD. A.

Дмитрий Александрович Кисель

dkis@yandex.ruНИИ скорой помощи имени Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute of Emergency CareRussian Federation20101708201803-42326Copyright © Шибаев Е.Ю., Иванов П.А., Кисель Д.А., 20182018Шибаев Е.Ю., Иванов П.А., Кисель Д.А.Shibayev E.Y., Ivanov P.A., Kisel D.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/290Введение

Введение. В настоящее время существует лишь один метод замещения практически любых по размерам дефектов покровных тканей, удовлетворяющий всем требованиям первичной пластики, — микрохирургическая аутотрансплантация тканевых комплексов на сосудистой ножке. Первичная пластика методом микрохирургической аутотрансплантации позволяет не только выполнять адекватные реконструктивные манипуляции на травмированной конечности, но и создает оптимальные условия для отсроченных хирургических вмешательств.

Материалы и методы

Материалы и методы. В НИИ cкорой помощи им. Н.В. Склифосовского аутотрансплантация васкуляризированных комплексов тканей для укрытия дефектов мягких тканей производится с 2000 г. За это время выполнена пересадка 57 лоскутов 57 пациентам с открытыми переломами костей конечностей. Для закрытия мягкотканных дефектов мы успешно применяли свободные аутотрансплантаты, включающие в себя мышцы и кожу.

Результаты и обсуждение

Результаты и обсуждение. Из 57 операций первичной микрохирургической аутотрансплантации тканевых лоскутов лишь в 4 случаях потребовалась экстренное вмешательство, в остальных – отсроченное. Все пересаженные аутотрансплантаты прижились полностью.

Выводы

Выводы. Применяемая нами методика дает возможность свести к минимуму ущерб, наносимый донорской области, и в конечном итоге улучшает как функциональные, так и эстетические результаты операции. Наш опыт позволяет рекомендовать более активное внедрение методов микрохирургической пластики в клиническую практику.

Background

Background. There is now only one method for replacement of virtually any integumentary defects differing in extent, which satisfies all the requirements of primary plastic repair – microsurgical autotransplantation of tissue units on a vascular pedicle. Primary plastic repair by microsurgical autotransplantation makes it possible not only to perform adequate reconstructive manipulations of an injured limb, but also to create the optimal conditions for delayed surgical interventions.

Materials and methods

Materials and methods. Since 2000, the N.V. Sklifosovsky Research Institute of Emergency Care has been performing autotransplantation of vascularized tissue units to cover soft tissue defects. For this time, 57 flaps have been grafted in 57 patients with open limb bone fractures. For closure of soft tissue defects, the authors have successfully applied free autografts comprising the muscles and skin.

Results and discussion

Results and discussion. Out of the 57 primary microsurgical autotransplantations of tissue flaps, only 4 cases required emergency intervention; the others needed delayed one. To close soft tissue defects, the authors successfully applied free autografts comprising the muscles and skin. All the transplanted autografts got implanted completely.

Conclusion

Conclusion. The used procedure furnishes a means of minimizing donor site damage and ultimately improves both functional and aesthetic surgical results. The authors’ experience permits one to recommend a more active introduction of microsurgical plastic methods into clinical practice.

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The authors declare that there are no conflicts of interest present.