胸三角皮瓣预扩张术方法的研究

Study of deltopectoral flap pre-expansion

目的探讨胸三角皮瓣预扩张术的方法并预防并发症的发生。方法本组患者214例，均行胸三角皮瓣预扩张术，术前设计选用大小合适的扩张器，术中注意剥离层次及范围，止血彻底，术后早期注水，适当固定。结果214例患者中，8例出现扩张器感染，2例扩张皮瓣局部破溃，经及时处理后均能继续扩张，皮瓣转移后血运良好，面颈部瘢痕修复效果理想。结论采用术前、术中、术后的综合措施预防胸三角皮瓣预扩张术并发症的发生，效果显著，为Ⅱ期手术打下良好的基础。

Objective To explore the methods of pre-expansion of deltopectoral flap for preventing the complications. Methods Total 214 suitable cases were included in the study. Pre-expansion of dehopectoral flaps was performed to treat these patients with suitable volume expanders, which also was needed to pay more attention to sufficient hemostasis and disjucting layer during the operation as well as early water flooding and ap- propriate immobilization after operation. Results All of 214 cases were expanded well with good blood supply except for 2 cases with local breakage during the expansion which could continue being expanded after prompt treatment. The repairing effect of scar on face and neck was ideal. Conclusion The combination of preoperative, intraoperative and postoperative intervention can effectively prevent the complications of dehopectoral flap pre-expansion, which can be the better preparation for the second stage operation.