应用扩张后胸三角皮瓣修复面颈部瘢痕

Repair of faciocervical scars by dilated flaps taken from thoracic deltoid region

目的探讨面颈部瘢痕修复的方法。方法本组患者68例,均行胸三角皮瓣预扩张,扩张后带蒂转移修复面部瘢痕,3周后断蒂,舒平皮管,修复剩余的颏颈部瘢痕。结果68例中61例皮瓣全部成活,效果良好,6例单侧皮瓣尖端部分血运障碍,痊愈后色素减退,1例单侧皮瓣坏死,植皮后封闭创面。结论预扩张的胸三角皮瓣转移治疗面部瘢痕,供区可拉拢缝合,皮瓣薄如真皮下血管网皮瓣,转移到面部,不臃肿,与周围正常组织匹配,是目前面颈部瘢痕治疗的理想方法。

Objective To explore the approach to repairing faciocervical scars. Methods There were 68 cases with faciocervical scars, all of whom were treated with the predilated flaps taken from the thoracic deltoid region. After dilated, the flaps together with their pedicles were transpositioned to repair faciocervical scars. Three weeks later, the pedicles were cut off, their skin tubes were diastolized and smoothed. The remaining faciocervical scars were repaired. Results Of the 68 cases, 61 achieved effective results with all the flaps surviving. Six cases showed achromatosis after healing because of the blood circulation disturbances. The remaining one case failed owing to the necrosis of unilateral flap and the blocked wound surfaces after the transplant. Conclusion The application of predilated flaps taken from the thoracic deltoid region is proved to be an effective way of repairing faciocervical scars since hook-in suture can be used to ensure, that the flaps are as thin as those vascular net flaps under the real skin and so when transferred to the facial region, the flaps will not swell and can well match with their peripheral tissues.