重症下肢開放骨折に対する遊離前鋸筋・広背筋連合皮弁の選択の意義

抄録

　Purpose: This study evaluated the treatment outcomes of soft tissue reconstruction using a free serratus anterior-latissimus dorsi combined flap for Gustilo type IIIB/C open fractures of the lower limb.　
　Methods: A retrospective study was conducted on nine male patients treated at our center between 2013 and 2023. The primary and secondary outcomes were flap survival, flap complications, donor-site morbidity, bone union, walking ability, and NRS scores.　
　Results: The median patient age was 43 years. Soft-tissue defects involved two or three anatomical regions. The flaps survived in eight cases; however, one case had complete necrosis, and another case required an additional flap due to ulcer formation. One patient experienced residual muscle weakness around the shoulder. Bone union was achieved in all the cases. Eight patients were able to walk independently, and the NRS scores ranged from 0 to 2.　
　Discussion: Free combined serratus anterior-latissimus dorsi flaps are reliable and effective for reconstructing extensive soft tissue defects and offer broad coverage and technical simplicity.