胸背动脉穿支皮瓣修复乳房缺损畸形的临床应用

Clinical Application of the Thoradorsal Artery Perforator Flaps for Reconstruction of Breast Defect and Deformity

目的探讨胸背动脉穿支皮瓣或预扩张后胸背动脉穿支皮瓣,在乳房缺损畸形重建中的临床应用。方法2007年8月至2014年4月,对23例乳房缺损畸形患者,采用预扩张带蒂胸背动脉穿支皮瓣修复5例,单纯带蒂胸背动脉穿支皮瓣修复18例,皮瓣大小为12 cm×22 cm^7 cm×12 cm。结果 23例患者术后皮瓣均完全成活,供区无血肿、血清肿等并发症发生。术后随访3~26个月,皮瓣成活良好,外形恢复较好。结论胸背动脉穿支皮瓣较薄,穿支血管蒂较长且走行恒定,预扩张后可提供较大面积的皮瓣,是修复乳房浅表组织缺损畸形的良好选择。

Objective To explore the clinical application of thoradorsal artery perforator flaps（TAP） for reconstruction of breast defect and deformity. Methods From August 2007 to April 2014, 23 cases with breast defect and deformity were treated. TAP flaps were used in 18 cases for breast reconstruction and pre-expanded TAP flaps were used in 5 cases. The size of flaps ranged from 12 cm×22 cm to 7 cm×12 cm. Results All the flaps were survived. No complication was observed.All the patients were followed up for 3-26 months. The flaps were well healed with lowest donor site morbidity. Conclusion The thordorsal artery perforator flap is thin and reliable with long vascular pedicle and constant direction, and could provide a large area of skin flap after pre-expansion. It is an effective method for breast reconstruction.