颈横动脉颈段皮支管型皮瓣修复面部瘢痕

Repair of facial scar with tubed pattern skin flap from the cervical cutaneous branch of transverse cervical artery

目的总结颈横动脉颈段皮支管型皮瓣修复面部瘢痕的临床经验。方法首先按面部瘢痕大小在胸部设计颈横动脉颈段皮支皮瓣，胸部皮肤不够时先行皮肤扩张；再切取皮瓣，使皮瓣近端卷曲缝合形成管型，远端构成皮瓣接口；再在面部瘢痕区切除一块瘢痕，伤口用管型皮瓣接口覆盖，待皮瓣与面部建立血运后训练管型皮瓣致血运良好；最后切断并展开皮管，切除面部剩余瘢痕，创面用管型皮瓣覆盖并缝合。结果采用颈横动脉颈段皮支管型皮瓣修复面部瘢痕患者35例，皮瓣成活率100％，其中20例0．5-1年后皮瓣削薄塑形，随访1～5年，疗效满意。结论颈横动脉颈段皮支管型皮瓣与面部皮肤相似度高，可切取面积大，是修复面部大面积缺损的理想皮瓣。

Objective To summarize the clinical experience of repairing facial scar with tubed pat- tern skin flap from the cervical cutaneous branch of transverse cervical artery. Methods Firstly, a skin flap in the cervical cutaneous branch of transverse cervical artery was designed at chest according to the size of facial scar. The chest skin would be expanded if it was not large enough. Secondly, a skin flap was cut, and the proximal end was rolled and sutured as a tube, whereas the remote end was formed an interface. Thirdly, the scar was removed from the facial scar area and the wound was covered with the tubed pattern skin flap interface. After a blood circulation was established between the face skin and the flap, the flap was trained so that it had plentiful blood supply. Lastly, the tubed pattern skin flap was cut off and open, the remaining facial scar was removed, and the wound was covered and sewed up with the sectioned tubed pat- tern skin flap. Results The facial scar 35 patients were repaired with tubed pattern skin flap from the cer- vical cutaneous branch of transverse cervical artery. The survival rate of flap was 100%. Twenty patients re- ceived thinning and shaping on flaps in 0. 5 to 1 year after surgery. All patients were satisfied with this re- pair within 1 ~ 5 year follow-up. Conclusions The tubed pattern skin flap in the cervical cutaneous branch of transverse cervical artery is of highly similar to the facial skin. In addition, the supply of the skin is e- nough. Therefore, it is an ideal flap to repair large facial skin defects.