遊離広背筋皮弁移植で初期治療を行った顔面重度熱傷の1例

摘要

Although skin grafting is the usual method for treating burn injuries,deep and extensive burns in which tissues such as bones are exposed require alternative methods.In this situation,free flaps are a good option, especially in the head and neck regions,where local flaps of sufficient size are not available.Conversely, primary burn reconstruction using a free flap has some problems such as thrombosis due to unstable blood coagulability and prolonged infection.We present a case of deep facial burn that was reconstructed using a latissimus dorsi musculocutaneous free flap in an early stage.Arterial thromboses occurred on days 5 and 6 postoperatively,and a thrombectomy was performed at each instance,resulting in the rescue of the flap. However,additional surgery was needed to manage a persistent infection under the flap.Using a free flap for acute burn reconstruction has some high risk,such as thrombosis and infection;nevertheless it is a useful option in that a one stage reconstruction is possible.