腹壁下动脉穿支皮瓣修复外阴癌根治术后创面的方法及效果

Application of DIEP to repair the wound after radical vulvectomy

目的 探讨应用腹壁下动脉穿支皮瓣修复外阴癌根治术后创面的方法及效果。方法 自2010年5月至2015年3月,对6例外阴癌的患者均采用广泛的外阴癌根治术,扩大切除所受累的外阴皮肤。根据切除后外阴组织缺损面积的大小,在腹壁切去相同大小的腹壁下穿支皮瓣,以一侧腹壁下动静脉为蒂,通过阴阜区皮下隧道转移至外阴,重建外阴形态。结果 6例患者切取腹壁下穿支皮瓣（6-10cm）×（12-17 cm）,术后皮瓣全部成活,Ⅰ期再造尿道口、阴道口外形满意。结论 采用腹壁下动脉穿支皮瓣修复外阴癌根治术后创面,皮瓣转移安全、方便,副损伤轻,术后外阴形态满意,是较好的外阴修复重建的方法之一。

Objective To study the method and effect of using the deep inferior epigastric perforator flap （DIEP） to repair the wound after radical vulvectomy. Method From May 2010 to March 2011, 5 cases of patients with carcinoma of vulva were treated byradical vulvectomy. Then DIEP was harvested from the abdominal wall and transplanted to repair the wound through subcutaneous tunnel under skin of mons pubis, using the deep inferior epigastric artery and vein on one side as vascular pedicle. The urethral orifice and vaginal orifice were also reconstructed in the same stage of operation. Results All DIEP （6-10 cm×12- 17 cm）survived well after operation with satisfactory appearance of the urethral orifice and vaginal orifice. Conclusion Application of DIEP is one of the best methods to repair the wounds after radical vulvectomy for the advantages like： safety, convenience, minor injury of donor site and satisfactory appearance.