颈胸双蒂V形扩张皮瓣修复颜面下部及颌颈部瘢痕挛缩

Reconstruction of the lower face and the anterior neck with a bipedicled expanded flap

目的 探讨面颈部瘢痕挛缩的修复方法。方法 采用在颈部及颈胸交界处扩张皮肤 ,以颈两侧为蒂形成颈部或颈胸部双蒂扩张V形皮瓣 ,向上推进移转修复颜面下部及颌颈部瘢痕挛缩 ,如果瘢痕不能一次性完全切除 ,则于颈部行二次扩张。结果 自 1990年起 ,为 11例烧伤瘢痕患者手术 ,皮瓣全部存活 ,效果满意。结论 颈部或颈胸部双蒂扩张V形皮瓣血运可靠 ,保证了皮瓣的存活率 ,由于系双蒂皮瓣可在面部减少缝合接口 ,是一种可行的手术方法。

Objective\ To explain a method for lower face and anterior neck reconstruction. Methods\ Tissue expanders were implanted subcutaneously beside the defect. When the skin was properly expanded, the bipedicled expanded skin flap was created and transferred to the lower face and the anterior neck. If the defect can not be repaired by one stage, the expanded skin was re expanded for the rest. Results\ 11 patients have been treated with this method since 1990. All flaps survived and all the defects have been successfully repaired with satisfactory results. Conclusion\ The bipedicled expanded flap, which provided good blood supply, improved the survival rate of the flap and reduced the incision scar on the face, is an effective surgical procedure.\;