๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Contraindications
Contraindications
Patients with chronic medical conditions or poor nutritional status may not be candidates for surgical reconstruction, as these conditions may hinder the ability of the individual to heal.118 Muscle spasms could compromise flap healing and should be controlled before planning surgery due to risk of dehiscence. In patients with ulcers in
close proximity to the anus, a diverting colostomy should be considered prior to surgery due to the risk of fecal contamination at the wound site. Smoking should also be stopped due to the increased risk of flap failure.105
When the defect is too large for a local flap, advancement may not be possible, since advancement flaps require a considerable amount of available skin at the base of the planned flap.119 Ulcers with greater depth and larger amount of subcutaneous tissue loss may be better suited for myocutaneous reconstruction.117