扩张后胸三角皮瓣修复面颈部较大面积皮肤软组织缺损(1)
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[摘要]目的：探讨应用扩张后胸三角皮瓣修复面颈部较大面积皮肤软组织缺损的效果。方法：自2006年以来，对我科收治的20例患者，其中17例面部瘢痕、2例颈部瘢痕和1例面部黑毛痣，在胸三角区置入300～400ml柱形扩张器，经3～5个月注水，注水后容量为500～1000ml获得足够的皮肤后，切除面颈部瘢痕，创面应用扩张后胸三角皮瓣转移修复，1月后断蒂，利用蒂部皮瓣修复剩余瘢痕切除后的创面。结果：共置入22个扩张器， 除1例扩张器外露，1例出现感染终止扩张，18例(20个)扩张器顺利扩张。皮瓣转移后2例皮瓣远端发生少量坏死，经换药或植皮后创面愈合，其余16例(18个扩张器)转移的皮瓣全部成活，皮瓣色泽厚度质地接近正常部位，患者和家属均满意，取得了很好的修复效果。结论：对于面颈部瘢痕或体表病变手术后的较大面积皮肤软组织缺损，应用扩张后胸三角皮瓣修复是一种很好的方法。
[关键词]胸三角皮瓣；扩张术；面颈部；修复
[中图分类号]R622[文献标识码]A[文章编号]1008-6455(2011)01-0006-03
Repairing the larger area of skin and soft tissue defects in face and neck by using dilated deltopectoral flaps
WANG Ji-hua,YANG Yun,ZHU Li-kun,ZHANG Jing-bo,HE Yong-jing,LI Ying
(Department of Plastic Surgery,the Second Affiliated Hospital of Kunming Medical College, Kunming 650101,Yunnan,China)
Abstract:ObjectiveTo discuss the effect of dilated deltopectoral flaps of repairing large area of skin and soft tissue defects in face and neck.MethodsSince 2006, the experiment of implanting cylindrical expanders with volume of 300~400ml in 20 cases of patients in this research have been implemented, including 17 cases of facial scar, 2 cases of cervical scar and 1 case of facial black pigmented nevus.Plenty of skin was obtained after 3 to 5 months injection of steriled water leading to 500 ~ 1000 ml volume of expanding space, following the implanting expanders. Then the facial and cervial scars were removed.The expanded deltopectoral flaps were used for repairing the surface of wound.After the skin flap pedicle division one month later, the skin flap pedicle was employed into restoring other surface of wound produced by removing residual scars.Results18 cases of expanding experiment were successful in the total 20 cases with the exception of1 case of expander exposure, 1 case of termination of the expansion by infection.After transferring the skin flaps,there were slight necrosis in vicinity of distal end of skin flaps,which were healed afer refil of drug or skin-grafting.The other 16 cases of transferred skin flaps all survived with the normal location of color, texture and thickness of flaps,which pleased the patients and their family.ConclusionThe method of application of dilated delropectoral for repairing large area skin and soft tissue on face and neck was excellent ......
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