用肌皮瓣轴型皮瓣修复严重放射性溃疡

Myocutaneous or axial flap for severe postradiation ulcer

鉴于大面积深度放射性溃疡的治疗采用换药、清创、游离植皮的方法效果不佳。文中介绍了近几年来10例13处病例的临床成功实践,认为采用彻底清创后以肌皮瓣、轴型皮瓣或局部旋转皮瓣及腹壁整形术原则,修复大面积严重的放射性溃疡是一项积极有效的可行方法,共已治愈10例13处放射性溃疡,皆获成功,应予提倡。

Debridement and grafting are the often used treatment for postradiation ulcer.However it is not effective for large postradiation ulcer,especially when large vessels,nerves or bones are in- volved.A method for such case is introduced.The procedure includes wide excision of abnormal tissue, complete debridement and skin or myocutaneous flap transfer.For lower abdominal ulcer,the principle of abdominal wall plastic surgery is employed for both wound-healing and abdominal reconstruction. Follow-up for half to five years showed good results without recurrence in all the cases.The method is proved to be practical and effective.