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Wound closure after malignant tumor excision
91
（和文抄録）
悪性軟部腫瘍切除後の適切な創閉鎖：再発症例での皮弁の必要性
1)
九州大学整形外科，2)九州大学病院形成外科
市ヶ谷
憲1)，花田麻須大1)2)，門 田 英 輝2)，吉 田
聖2)，薛
遠藤
誠1)，松 本 嘉 寛1)，中 島 康 晴1)
宇 孝1)，
近年，悪性骨軟部腫瘍の集学的治療の進歩により再発症例においても患肢温存が可能になってきて
いる．創閉鎖の成否は深部感染の予防の鍵を握っている．
今回我々は，146 人の軟部腫瘍広範切除後患者の再建法と臨床成績を調査した．
初回適切切除は 103 例，初回不適切切除は 15 例，再発は 28 例であった．
直接縫合が行えた 107 症例のうち 105 例は二次縫合以外の追加手術なしで上皮化したが，2 例で追
加再手術を要した．適切切除症例では 80％で直接縫合が行えたのに対して，不適切切除症例では
33％しか直接縫合が行えず，40％で皮弁を要した．再発例で再建を要する場合は全て皮弁術であった．
不適切切除症例は皮膚再建の準備が必要である．再発症例は皮弁による再建を準備すべきである．
キーワード：悪性軟部腫瘍，不適切切除，再建，リコンストラクションラダー，創閉鎖
...