斜方肌肌皮瓣修复头颈部难治性创面

Repairment of refractory wound surface of head and neck with trapezius myocutaneous flap

[目的]介绍斜方肌肌皮瓣在修复头颈部难治性创面中的应用,提供头颈部复杂创面修复的方案。[方法]逆行掀起以颈横动脉降支为轴型血管的带蒂斜方肌肌皮瓣,皮瓣面积最大达32 cm×10 cm,肌肉血管蒂长17 cm,局部转移修复头颈部难治性创面23例。[结果]23例头颈部不同部位难治性创面经带蒂斜方肌肌皮瓣转移修复后,22例全部成活,1例远端约1 cm黑痂愈合。[结论]带蒂斜方肌肌皮瓣,血供可靠,切取面积大,供区隐蔽,对肩部功能影响小;采用逆行法切除皮瓣,操作简单,不易损伤血管蒂;用于修复头颈部难治性创面,效果满意。

[Objective] To introduce the use of trapezius myocutaneous flap to repair the refractory wound surface of head and neck. [Methods] A trapezius myocutancous flap with the axial pattern blood vessel of descending branch of transerse cervical artcry （TCA） was prepared, the maximum area of skin flap was 32 cm×10 cm and the length of blood vessel pedicel in muscle was 17 cm. A total of 23 cases of refractory wound surface of head and neck were repaired by this trapezius myocutaneous flap. [Results] 22 cases of refractory wound surface of head and neck were success and 1 case heal with dark crust about 1 cm. [Conclusion] The blood supply of trapezius myocutaneous flap is reliabe, the area is large, the donor site is concealment, and has little effect to the function of shoulder. It is content to repair refractory wound surface of head and neck.