胸大肌肌皮瓣坏死原因探讨

Analysis on the Causes of Necrosis of Pectoralis Major Myocutaneous Flaps (PMMF)

目的:回顾分析胸大肌肌皮瓣坏死这一并发症的成因,从而发现应对方法。方法:142例胸大肌肌皮瓣转移缺损修复术的病例进行回顾性分析,重点探讨术后皮瓣坏死的原因。结果:35例出现并发症患者中,15例坏死。其中2例完全坏死,13例部分坏死。结论:肌皮瓣坏死是由于患者全身情况、皮瓣制取方法、供受区情况及术中术后处理措施等多因素的影响。应对的关键在于保护肌皮瓣的血运,充分的术中止血和术后引流及良好的口腔护理。

Objective： To explore the cause of pectoralis major myocutaneous flap necrosis. Methods： One hundred and forty -two cases who received PMMF operation were retrospectively studied and factors associated with necrosis of flaps were evaluated. Results： 15 necrotic cases were encountered in 35 cases of PMMF operation complications, which included 2 cases of entire necrosis of flap, 13 cases of partial necrosis. Conclusion： The whole circumstance of patients, method to prepare PMMF, the status of donor and recipient areas and the management during and after operation were related to the necrosis of PMMF. Proper preservation of blood supply for the flap, complete haemostasis during operation, good drainage, and adequate postoperative nursing were very important to prevent the flap necrosis.