锁骨上岛状皮瓣修复颈部深度烧伤创面

Repair of deep burn wound of neck with supraclavicular island flap

目的观察锁骨上岛状皮瓣修复颈部深度烧伤创面的治疗效果。方法选择笔者单位2009年1月-2011年6月收治的颈部深度烧伤患者6例，烧伤总面积为6％～22％，其中Ⅲ度为3％～22％TBSA；颈部创面面积为12cm×5cm～15cm×8cm，均为Ⅲ度，其中1例为肉芽创面。颈部创面行清创、切除焦痂或肉芽组织后，设计并切取与创面面积等同的锁骨上岛状皮瓣封闭创面。4例供区良接缝合，2例供区游离植皮观察术后皮瓣成活及供区愈合情况，随访颈部术区外观及功能恢复情况．结果6例患者术后皮瓣完全成活，供区愈合良好。随访6～12个月，皮瓣外观良好并伴有感觉．颈部可正常后仰。仪皮瓣边缘及供区出现线状瘢痕，但不影响患者整体外形及功能。结论啦用锁骨上岛状皮瓣治疗颈部深度烧伤创面，颈部外形和功能恢复良好．不失为一种较佳术式。

Objective To observe the therapeutic effect of supraeiavieular island flap in repairing deep burn wound of neck. Methods Six patients with deep burn of neck hospitalized from January 2009 to June 2011 were enrolled in the study. Their total burn area ranged from 6% to 22% TBSA, of which full-thickness area ranged from 3% to 22% TBSA. The neck wound ranged from 12 cm × 5 cm to 15 cm× 8 cm in area, and they were all full-thickness in depth. One of the neck wounds was covered with granulalion tissue. Patients underwent either dehridement and esehareetomy or excision of granulation tissue for the neck wound, and they were covered with supraelavicular island flap designed with the size corresponding to that of wound area. Four donor sites were sulured directly. The other two dnnor sites were covered with free skin graft. Survival of flaps and healing of dnnor siles were observed. The appearance and function recovery of operative regions were fidlowed up. Results Supraclavicular island flaps of 6 patients survived as a whole. All the donor sites healed well. Flaps with satisfactory appearance and feeling sensation, accompanied by unlimited extension of neck were observed in the follow-up duration from 6 to 12 months. Sears ob- served in the flap edge and the donor sites were linear, anti they did not affect the overall appearance and function of patienls. Conclusions Supraelavicular island flap is a good choice the repairing deep hurn wound of neck, and it gives a good shape and function recovery of the neck.