预扩张颈肩峰或颈肩胛部皮瓣修复颈部瘢痕挛缩

The repair of cervical scar contracture with pre-expanding cervicoacromial or cervicoscapular flap

【目的】为解决局部皮辩修复颈部瘢痕挛缩后供区出现的并发症,行颈肩峰或颈肩胛部皮瓣预扩张后转移并观察其疗效。【方法】对18例颈部瘢痕挛缩患者,行颈肩峰或颈肩胛部皮瓣预扩张术(扩张皮瓣最大28cm×12 cm),二期行皮瓣转移修复颈部瘢痕切除后创面。【结果】18例患者中,11例为一侧皮瓣预扩张,7例为双侧皮瓣扩张后转移,扩张后皮瓣能满足修复颈部瘢痕挛缩需求的面积,无1例皮瓣坏死,供瓣区能直接缝合。【结论】颈肩峰或颈肩胛部皮瓣,取材部位隐蔽,预扩张后转移修复颈部瘢痕切除后创面,既可为创面提供较大的组织修复材料,又可防止供区出现的并发症,特别适合于前胸部有瘢痕或需要供瓣区刀口隐蔽的颈部瘢痕挛缩患者。

[Objective] To appraise the effect of resolving the donor site complications in cervical scar contracture repairment with cervicoacromial or cervicoscapular flaps. [Methods] From January, 1996 to December, 2005, 18 cases suffered with cervical scar contracture were sustained with pre-expansion of cervicoacromial or cervicoscapular flaps and secondary transposition after cicatrectomy. [Results] 11 cases were performed with lateral flaps, 7 cases with bilateral flaps. The transposed flaps repaired the lesions satisfactorily. No necrosis occurred. The donor sites were sutured directly. [ Conclusions] The cervicoacromial and cervicoscapular flaps could offer abundant repairing materials for cervical scar contracture. Due to pre-expansion, donor site complications could be prevented. It is ideal for the patients with thoracic cicatrices and the patients appealing secluded donor sites.