颈肩峰区跨区供血轴型扩张皮瓣修复颈部瘢痕挛缩

Expanded cervieo-acromial skin flap of crossing supply axial pattern for the repair of cervical cicatricial contracture

目的探讨颈肩峰区跨区供血轴型扩张皮瓣的解剖学特征及应用于修复颈部瘢痕挛缩的临床效果。方法应用颈横动脉分支和胸肩峰动脉吻合支跨区供血，形成前界为锁骨、后界为肩胛岗、外界为肩峰的颈肩峰区的扩张皮瓣，以颈侧为蒂转移修复较大面积的颈部软组织缺损。结果15例患者的19个颈肩峰扩张皮瓣（面积最大为23cm×16cm）全部成活，颈部畸形矫正良好。结论颈肩峰区跨区供血的吻合支丰富，于深筋膜浅层进行扩张后皮下脂肪层及皮肤较薄，可以形成较大面积的扩张皮瓣，以颈横动脉颈段皮支为轴型血管，转移修复颈部较严重的瘢痕挛缩畸形，是一个良好的手术方法。

Objective To investigate the blood supply of an expanded skin flap from cervico-ac- romial region and its application in the repair of cervical cieatricial contraeture. Methods The expand ed skin flap pedicled was prepared with arteries of lateral neck, blood supply crossing and abundant anastomotic branchea of the neck-should blood vessels, the frontal bound of which is clavicle, the un- derneath bound of which is spine of scapula, and the lateral bound of which is acromion, to repair the large soft tissue defects on neck. Results All the 19 flaps of 15 patients were survived. The maximum size was 23 cm × 16 cm. Postoperative follow-up showed that the cervico-mandibular function and the external appearance of the flaps were satisfactory. And the scar in donor sites seemed to be neglect- able. Conclusions The blood supply of the cervico-acromial flap is abundant, the subcutaneous fat and skin is quite thin after expended. We can harvest a large expanded skin flap. Reparation of cervical cic atricial contracture with expanded cervico-acromial flap pedicled with arteries of lateral neck could be recommended.