颈胸皮瓣在颌面部创面修复中的应用

The Application of a Cervicothoracic Flap in Repairing Maxillofacial Traumatic Wound

目的探索颈阔肌肌皮瓣及向胸部延伸形成的颈胸皮瓣用于Ⅰ期修复颌面部创面的效果。方法对45例因颌面部烧伤瘢痕、肿瘤切除、外伤等原因所致的颌面部创面,利用颈阔肌肌皮瓣Ⅰ期修复16例,颈胸皮瓣Ⅰ期修复29例,其中双侧颌面部创面同时修复者10例。结果 45例患者除部分病例的颈胸皮瓣远端出现轻度水疱和肿胀,7 d左右肿胀消退,水疱表皮脱落外,未发生1例皮瓣坏死。结论颈胸皮瓣Ⅰ期修复颌面部创面,皮瓣供血良好,厚薄适宜,色泽红润,功能与外形良好,疗效满意。

Objective To explore the clinical efficacy of a platysma myocutaneous flap and a cervicothoracic flap in the first-period repair of a maxillofaeial wound. Methods A total of 45 patients with maxillofacial wounds resulting from burn sear and tumor excision, trauma and etc. were treated with a platysma myoeutaneous flap and a cervieothoracic flap. Among them, 16 patients were treated with a platysma myocutaneous flap while 29 patients were treated with a cervieothoraeic flap for primary healing, andl0 patients with bilateral maxillofacial wounds were also treated, so a total of 55 skin flaps were used,. Cervicahhoraeic donor sites were relatively larger with the smallest area being 11cm × 3.5cm and the largest one being 20cm × 7. 5cm, The width of the flap pedicle was on average 2. 5cm - 3.5cm and the ratio between the width and the length of the skin flap was 1： 2. 5 -1：1.5 with the transferring angle being 160° -180° and there was no ＂cat＇s ear＂. Results A total of 45 eases with 55 skin flaps were all successfully treated with no skin flap necrosis except for some mild blisters and mild swelling at the distal of eervicalthoracic flaps. However, the swelling subsided and the blister skin fell off about 7 days later. Conclusion The treatment method is feasible in repairing maxillofaeial wounds with primary healing since it can achieve good blood supply, appropriate flap thickness, matched colors, and satisfactory function and appearance.