超长扩张后颈肩背反流轴型皮瓣在修复颈胸部瘢痕挛缩畸形中的应用

How Extra Long Expanding Neck-shoulder-back Reflux Axial Skin Flap Is Used for Repairing Neck-chest Cicatricial Contracture Malformation

目的探讨扩张后的颈肩背反流轴型皮瓣在修复颈胸部瘢痕挛缩畸形中的临床应用。方法对临床9例患者应用该术式治疗颈胸部瘢痕挛缩畸形,在确定的血管解剖基础上,设计背部皮瓣,测定扩张后的组织量与所需的组织量的最佳比例关系。结果利用超长扩张跨区供血的颈肩背反流轴型皮瓣联合应用治疗经胸部瘢痕挛缩畸形,以其特有的优势弥补了单纯轴型皮瓣修复面积不足,血管蒂较短、血管欠灵活等不足,取得修复区域皮瓣弹性色泽良好,毁损部位功能恢复满意的良好效果。结论利用扩张后的颈肩背反流轴型皮瓣治疗颈胸部瘢痕挛缩畸形,是一种手术操作简单,效果好,值得推广的方法 。

Objective To discuss the clinical application of how the expanding neck-shoulder-back reflux axial skin flap is used for repairing the neck-chest cicatrical contracture malformation.Methods We treated 9 patients with neck-chest cicatricial contracture malformation in this experiment.For each patient,we used the confirmed vascular dissection methodology on the skin flap of the back.In other words,we used a certain portion of each patient＇s back,known as reflux axial skin,and determined what each person needed in his neck and chest.Results Using the extra long transregional blood supply neck-shoulder-back reflux axial skin flap to treat a neck-chest cicatricial contracture malformation is better than using the simple axial skin flap.The reason is because it covered the surgery area and the old method using the simple axial skin flap did not provide enough skin.In addition,the old method relied on the vascular pedicle,which is too short,and the vein in the skin flap is not flexible.Using this new method can produce excellent results.For example,the skin area in the neck and chest can have better elasticity and color.Also,the part of the back in which skin was removed can recover very well.Conclusion Using the extra long neck-shoulder-back reflux axial skin flap to treat a neck-chest cicatricial contracture malformation is worth using in more hospitals because the surgery is simple and the effect is very good.