体表软组织恶性肿瘤根治术后创面的一期显微修复

The one-stage microscopic repair of soft tissue defect caused by excision of malignant tumour

目的探讨体表软组织恶性肿瘤根治术后一期显微修复重建的方法思路和临床疗效。方法2015年6月至2017年3月,本组共32例肿瘤行扩大根治切除术后体表软组织大面积缺损伴功能丧失,平均缺损面积10.0 cm×12.0 cm。通过评估创面的缺损范围、周围解剖学特点等因素,在运用显微技术保护皮瓣血供和减少供区损伤的基础上,采用各类游离皮瓣、带蒂皮瓣、肌皮瓣或局部皮瓣,一期修复软组织缺损。结果32例皮瓣完全成活。术后随访4~18个月,皮瓣色泽接近周围皮肤,质地良好,无臃肿,皮肤保护性感觉恢复可,供区无明显瘢痕增生,无畏寒,无疼痛等并发症出现。结论体表恶性肿瘤根治术后根据不同部位及肿瘤切除创面特点选择不同类型皮瓣进行一期显微修复,可以获得良好的临床疗效。

ObjectiveTo explore the method and clinical efficacy of microsurgical reconstructive surgery after malignant tumors radical resection on the surface. MethodsFrom June, 2015 to March, 2017, a total of 32 patients in this group underwent radical resection of malignant tumors. All of them resulted in a large area of soft tissue defect with loss of function. The average defect area was 10.0 cm×12.0 cm. All types of free flap and pedicle flap were selected. Myocutaneous flaps or local flaps were used to repair large areas of soft tissue defect on the basis of microsurgical techniques to protect the blood supply of the flaps and to reduce the damage to the donor area by evaluating the defect size, surrounding anatomical characteristics, and other factors. ResultsThirty-two flaps survived completely. After 4 to 18 months of followed-up, the color of flap was close to that of the surrounding skin. The texture was good. There was no bloated swelling, and the skin protective sensation was restored. There was no obvious scar hyperplasia, no chills, no pain and no other complications in the donor site. ConclusionAfter the radical mastectomy of the body surface, different types of flaps can be selected for the first-stage microsurgery according to the characteristics of the different parts and the tumor excision wounds to obtain a good clinical efficacy.