肩背部穿支螺旋桨皮瓣修复皮肤恶性肿瘤创面的体会

Use propeller perforator flap to repair the skin malignancies wound on the back of the shoulder

目的探讨肩背部任意穿支皮瓣修复皮肤恶性肿瘤切除后创面的疗效。方法自2012年1月至2016年6月．收治肩背部皮肤软组织肿瘤患者12例．其中皮肤隆突纤维肉瘤8例．皮肤基底细胞癌3例．皮肤鳞状细胞癌1例。术前借助多普勒超声探查设计穿支皮瓣．术中扩大切除，并行切缘基底标记冰冻病理检查无肿瘤侵犯后．根据创面以及穿支血管的实际情况适当调整切取螺旋桨皮瓣，转移覆盖创面及供区。定期进行随访。随访观察局部肿瘤有无复发、皮瓣有无溃疡、皮瓣的质地、皮瓣的感觉。结果12例均获得随访，时间为6-48个月，皮瓣全部成活，肿瘤均未复发，皮瓣不臃肿，质地与周围组织一致，无溃疡形成，无明显的凹陷畸形，外观满意．感觉恢复不理想．供瓣区均一期愈合。结论采用肩背部穿支螺旋桨皮瓣修复邻近皮肤恶性肿瘤创面，其操作简便、血供可靠、旋转方便、修复后外观优良，是修复肩背部恶性肿瘤创面的理想皮瓣之一。

Objective To discuss the therapeutic effect of free perforator flap of the humeral back and the healing of the wound after the removal of the malignant tumor. Methods From January, 2012 to June, 2016, 12 cases were treated as soft tissue tumors on shoulder, including 8 cases of skin juga fibrosarcoma, 3 cases of basal cell carcinoma, squamous cell carcinoma of the skin in 1 case. Preoperative using doppler ultrasound probe design perfo- rator flap to expand resection, intraoperative cut edge basal tag frozen pathological examination without taking skin flap after the tumor invasion, according to the wound and wear the appropriate adjustment design of perforator flap. Followed-up to observe recurrence, flaps or ulcers, and the texture of the flap and the feel of the flap. All patients were followed-up regularly. Results All 12 patients were followed-up for 6-48 months. The flaps were all alive. The tumor did not relapse, and the flap was not swollen. The texture was consistent with the surrounding tissue. There was no ulceration of the flap. No obvious depression defoimity. The outlook of flaps was satisfied, but the feeling was not.The doror sites were closed directly. Conclusion Adjacent using humeral back free perforators flap to repair the defect after tumor resection on shoulder is an easy operation. It is one of the ideal flaps to repair a malignant tumor on the back of the shoulder.