狭长窄蒂皮瓣在老年人皮肤癌治疗中的应用

Application of along and narrow pedicle flap in treatment of skin tumors in aged patients

目的探讨狭长窄蒂皮瓣在老年肿瘤切除后软组织缺损修复中的应用及成活机制。方法设计蒂部位于肿瘤切除后创面旁沿知名或穿支血管走向的狭长窄蒂皮瓣，用于老年人肿瘤切除后软组织缺损的修复。皮瓣切取最大面积12cm×10cm，最小3cm×4cm．蒂宽1．0～1．5cm．蒂长2～8cm。结果共17例，14例Ⅰ期成活，外形良好．3例因早期包扎不当，延迟愈合。结论老年人皮肤组织细胞代谢率低，移植后皮瓣组织本身的耐缺血缺氧能力强，设计狭长窄蒂皮瓣修复老年肿爝切除后软组织缺损．较易成活，且窄蒂狭长，转移窬易．皮瓣不臃肿，同时利于肿瘤的早期综合治疗．是老年肿瘤术后修复较理想方法。

Objective To investigate the application and survival mechanism of a long and nar row pedicle flap which was used to repair the tissue defects after removal of tumor in aged patients. Methods The long and narrow pedicle flap was designed with its pedicle located beside wound surface along the pathway of well-known or perforating branch blood vessel to repair the defect caused by re- moving the tumor in aged patients. The size of the flaps ranged from 3 cm × 4 cm to 10 em ×12 cm. The length and width of the pedicle ranged 2 - 8 cm and 1.0 1.5 cm. Results This flap was used in 17 cases. The flap was survived well in 14 patients, and healed later in other 3 patients because of wrong bandaging in earlier period. Conclusions The capability of bearing ischemia and hypoxia of the flap tissue is stronger after transfer owing to low metabolic rate in the skin tissue in aged patients. The flap is easily survived by repairing the tissue defects after removal of tumors in aged patients with the long and narrow pedicle flap. The pedicle of flap is narrow and long, and the transposition of the nar- row pedicle flap is easy. The postoperative appearance is satisfactory. It is an ideal choice for repairing the defect caused by removal of tumor in aged patients.