颈横动脉颈段皮支岛状扩张皮瓣修复颈部瘢痕挛缩

Repair of cervical scar contracture with expanded island flaps based on cervical cutaneous branch of transverse cervical artery

目的探讨以颈横动脉颈段皮支岛状扩张的皮瓣修复颈部瘢痕挛缩的方法、效果及注意事项。方法对11例颈部瘢痕挛缩患者先行Ⅰ期颈横动脉颈段皮支供血范围内的皮肤软组织预扩张术，Ⅱ期采用以颈横动脉颈段皮支为蒂的扩张岛状皮瓣（切取的扩张皮瓣最大17．5cm×8．0cm）和扩张后任意型皮瓣转移相结合，修复颈部瘢痕切除、挛缩松解后形成的创面，其中3例供区直接缝合，8例供区使用皮片覆盖。结果11例皮瓣全部成活，术后6～18个月随访，颈部轮廓和颈部功能获得明显改善。结论扩张的颈横动脉颈段皮支岛状皮瓣具有取材范围较大，旋转容易，相对隐蔽，皮瓣厚度、色泽、质地与颈部接近等优点；是修复颈部瘢痕挛缩较理想的方法。

Objective To explore an ideal surgical treatment for cervical scar contracture. Methods From January, 2005 to December, 2008, 11 cases of cervical scar contracture （ Ⅱ-Ⅲ ） were treated with the expanded flaps based on the cervical cutaneous branch of transverse cervical artery. At the first step, one or two soft tissue expanders were implanted beneath the skin at the clavicular-pectoral region. At the second step, after fully expanding, an expanded clavicular-pectoral flap that based on the cervical cutaneous branch of transverse cervical artery was designed and raised completely according to cervical cutaneous defect, And then, the flap was transferred to reconstruct the defect in cervix. The donor area was closed directly or covered with graft. Results The 11 cases were performed with unilateral flaps based on the cervical cutaneous branch of transverse cervical artery. No necrosis occurred. And the cervical contour and function have been mended. All of them had been followed up for 6-18 months with satisfactory resuits. Conclusions This procedure can be very useful for the plastic and reconstruction surgeons who are confronted with a difficult case of cervical scar contracture. By this means, a lot of materials of reparation with similar color, and texture can be obtained. And this method is simple, safe, and effective.