胸三角岛状皮瓣一期修复对侧胸壁大块深度缺损

Transposition of Delto-pectoral Island flap For The Repair of Defects of Oppsite Chest Wall

目的:探讨前胸壁大块深度缺损一期修复的方法。方法:设计应用第2、3肋间前胸穿支血管为蒂的胸三角岛状皮瓣,远端三角肌部形成真皮下血管网皮瓣,通过皮下隧道或明道,转位修复对侧胸壁大块深度缺损。结果:除1例皮瓣伤口延期愈合外,其余皮瓣均获完全存活。随访4年-3月,伤口愈合稳定,外形恢复较满意;结论:第2、3肋间前胸穿支血管为蒂的胸三角岛状皮瓣是提供对侧胸壁大块深度缺损简便有效的一期惨复方法。

Objective: To find a better method of repairing major defects of the chest wall. in one stage. Methods : The delto - pectoral island flaps were devise and applied. The blood supply of the flap is from the second, and third anterior perforator of the internal mammary artery and the subcutaneous fat of the distant. 9 patients with the defects of chest wall (male 4 and femal 5) caused by a redical mastectomy (5 cases), dermatofi-brosarcoma (2 cases) , carcinoma of scar (1 case), unstable atrophic scar ( 1 case) were, treated with the flap. The flaps were 12 - 16cm × 6 - 7cm in size and donor sites were closed primarily in 7 cases, local V - Y flap in 1 case, split skin graft in 1 case. Results: The flaps in 9 cases totally survived. The appearence of the (lap was satisfactory after 3 months to 4 years follow - up. Conclusion: This flap may be useful in one - stage repairing of major defects of the chest wall.