观察自体脂肪颗粒移植修复肢体腔隙性软组织缺损的临床效果。

2017年9月至2019年6月，选择武汉大学中南医院创伤与显微骨科收治的14例腔隙性软组织缺损病例，缺损面积：1.5 cm×2.0 cm ～ 4.0 cm×6.0 cm，缺损深度：3.0～7.0 cm。彻底清创后制备自体脂肪颗粒，采用Coleman法制备脂肪颗粒，将脂肪颗粒注射到缺损周围软组织内并填充于腔隙内，表面覆盖凡士林纱布，每周打开凡士林纱布观察组织缺损部位变化，连续随访了解创面修复情况至创面愈合。

所有患者均获得12周随访，组织缺损部位在治疗后2周观察到大量肉芽组织生长，缺损面积缩小约(47.5±5.5)%。12例在治疗后皮肤软组织缺损面积缩小直接愈合，平均愈合时间(24.2±4.5) d；1例皮肤软组缺损伴骨质缺损在治疗后1周，部分移植脂肪坏死，行局部皮瓣移植术后愈合；1例术后5 d感染脂肪液化坏死，实施清创术控制感染后换药愈合。

脂肪颗粒移植对肢体腔隙性软组织具有修复作用，能够促进肉芽组织生长，加速软组织缺损重建。

To observe the clinical effect of lacunar soft tissue defect of the limbs repairing by autologous fat granule transplantation.

From September 2017 to June 2019, 14 patients with lacunar soft tissue defects were treated in the Department of Trauma and Micro Orthopedics, Zhongnan Hospital of Wuhan University, the defect area was 1.5 cm×2.0 cm-4.0 cm×6.0 cm, the defect depth was 3.0-7.0 cm. The fat particles were prepared by Coleman method for transplantion after thorough debridement, and the fat particles were injected into the soft tissue around the defect and filled in the cavity.The surface was covered with vaseline gauze and the vaseline gauze was opened every week to observe the change of the tissue defect site. Continuous follow-up was conducted to understand the wound repair until the wound healing.

All patients were followed up for 12 weeks. A large number of granulation tissue growth was observed at the defect site after 2 weeks of treatment, and the defect area was reduced about (47.5±5.5)%. In 12 cases, the area of skin and soft tissue defect was narrowed and healed directly after treatment, with an average healing time of (24.2±4.5) d; in one case, the skin and soft tissue defect was accompanied by bone defect after treatment for one week, partial transplantation of fat necrosis and local flap transplantation were performed for healing; one case was infected with fat liquefaction and necrosis 5 days after the operation. Debridement was performed to control the infection and heal after wound dressing.

Fat transplantation has a positive effect on the repair of limb lacunar soft tissue, can promote the growth of granulation tissue, accelerate soft tissue reconstruction, and is suitable for limb lacunar soft tissue defects.