上臂真皮下血管网皮瓣与面颌部瘢痕瓣置换移植术

Interchange of facial scar flap with upper arm subdermal vascular network skin flap to improve facial appearance

目的观察上臂真皮下血管网皮瓣修复烧伤患者面颌部瘢痕瓣带蒂置换移植后的效果. 方法根据9例患者面部瘢痕大小,按逆转计划法于上臂前内侧设计横行皮瓣,上臂形成真皮下血管网皮瓣,长宽比例(1.0～1.5)∶ 1.0;面部瘢痕瓣长宽比例为(1.0～1.2 )∶ 1.0.用皮瓣覆盖面部创面,上臂供区创面缩小后应用带蒂面部瘢痕瓣修复,相互带蒂置换移植,术后14-16 d断蒂. 结果 9例患者皮瓣与瘢痕瓣置换移植后,两瓣全部成活,外形恢复较好. 结论上臂真皮下血管网皮瓣与面颌部瘢痕瓣带蒂置换移植术,是修复烧伤患者面颌部大范围瘢痕较好的方法之一.

Objective To evaluate the result of subdermal vascular network skin flap raised from the upper arm to interchange with a facial skin flap carrying a scar resulted from previous burn. Methods A transit flap was designed in the anterior medial aspect of the upper arm according to the reverse design method. The subdermal vascular network flap in the upper arm with length-width ratio less than 1.5∶1 was raised with the pedicle located outside of the intermuscular septum of musculus biceps/triceps brachialis. The length-width ratio of the facial scar flap should be less than 1.2∶1. The two flaps were cross-grafted to repair the facial wound left by raising the scar flap. The pedicles of the flaps were divided on 14～15 post-operative days (PODs). Results The two flaps survived with satisfactory appearance in 9 patients with this method. Conclusion Interchange of facial scar flap with subdermal vascular network skin flap from the upper arms could be a new, reliable and effective method for the facial plastic surgery.[