扩张后背阔肌肌皮瓣在乳房区瘢痕挛缩修复中的临床应用

Clinical application of expanded latissimus dorsimusculo cutaneous flap in repairing scar contracture in breast area

目的探讨应用扩张后背阔肌肌皮瓣修复乳房区瘢痕挛缩的临床疗效。方法 2010年7月—2015年7月收治乳房区瘢痕挛缩患者14例,全部患者Ⅰ期均行同侧背阔肌下置入皮肤软组织扩张器,Ⅱ期部分切除并松解乳房区瘢痕,应用扩张后背阔肌肌皮瓣覆盖遗留创面,供瓣区直接拉拢缝合。结果 14例患者中,乳房区瘢痕挛缩均得到充分松解修复,术后切口Ⅰ期愈合,肌皮瓣未发生血运障碍,因用于修复的组织量充足,所有病例均取得满意的外形效果。结论扩张后背阔肌肌皮瓣是治疗乳房区瘢痕挛缩安全有效的方法。

Objective To investigate the clinical effects of using expanded latissimus dorsimusculo cutaneous flap on repairing scar contracture in the breast area. Methods 14 patients who underwnt 2-stage surgery treatment for chest scar contracture deformity in our department from July 2010 to July 2015. The first stage operation was to place the skin soft tissue expander under latissimus dorsi muscle. The second stage was to use expanded latissimus dorsimusculo cutaneous flap to cover the defect by partial excision and remission of chest contracture scar. The donor site was then closed primarily. Results All 14 patients who had sufficient remission of scar contracture of the breast and chest, and healed by first intention, has no disorder of blood supplying in the latissimus dorsimusculo cutaneous flap, were satisfied with the post-operation appearance of the breast and chest because of the sufficient quantity of musculo cutaneous flap. Conclusion Expanded latissimus dorsimusculo cutaneous flap is safe and effective method in the repair of scar contracture deformity in the breast area.