皮瓣延迟术改善局部静脉瘀血扩张皮瓣血供的临床应用

Clinical application on delaying to improve supply of expanded flap with venous congestion

目的:利用皮瓣延迟术增加局部静脉瘀血扩张皮瓣成活面积的方法。方法:扩张器注水后期有时出现扩张皮瓣局部缺血、甚至坏死。利用正常组织和血供行皮瓣延迟术,阻断除蒂部外大部分血供。术后14天再切取扩张皮瓣转移修复全损创面。结果:2006年～2011年,应用本法为15例出现局部血供障碍的扩张皮瓣行延迟术,皮瓣长宽比例为3∶1。术后皮瓣血运良好,成活100%。结论:扩张皮瓣延迟术能调整扩张皮瓣供血,增加了部分血供障碍扩张皮瓣的成活面积。

Objective To introduce the method of flap delaying to enlarge the survival area of an expanded flap with venous congestion. Methods At the later of enough injection,venous congestion was often occurred in skin expander, even local necrotic flap.The delaying was performed based on normal parts and supplying vessels,cut off the most supply except the pedicle. After 14 days,transfered the expanded flap to repair the defect. Results Since 2006 to 2011,this technique has been used in 15 patients which with venous congestion,length width ratio was 3：1. All the expanded flaps survived completely, with reliable blood supplement. Conclusion The technique of delaying can adjust the flap blood supply,enlarge the survival area of the