Pacman皮瓣在皮肤软组织缺损中的应用

The application of Pacman flap in reconstruction for skin and soft tissue defects

目的探讨Pacman皮瓣修复皮肤软组织缺损的临床效果。方法回顾性分析2015年4月至2018年4月北京大学人民医院收治的18例患者的临床资料,其中男8例,女10例,年龄18~87岁,中位年龄60岁。良性病变8例,恶性肿瘤10例。面部12例,躯干3例,四肢3例。病灶切除后缺损面积0.9 cm×0.9 cm^10.0 cm×9.0 cm,应用Pacman皮瓣进行修复。在缺损旁设计皮瓣,并在靠近缺损侧皮瓣下方剥离形成2个三角,将2个三角处皮瓣对位缝合后,将皮瓣向缺损处推进覆盖缺损。结果本组18例患者皮瓣完全成活,2例出现血肿,经清创后愈合。术后随访2~20个月,中位时间9个月,患者对形态和功能均满意。结论 Pacman皮瓣修复皮肤软组织缺损,方法简单、效果良好。

Objective To introduce the experience in skin and soft tissue defects reconstruction using Pacman flap. Methods From April 2015 to April 2018, clinical data of 18 patients using Pacman flap for soft tissue defect repair were reviewed. They were 8 males and 10 females, aged from 18 to 87 years (median age of 60 years). Eight patients had benign lesions, but 10 patients had malignant tumors. The defects were on face (n=12), trunk (n=3), and limbs (n=3). The size of tissue defects ranged from 0.9 cm×0.9 cm to 10.0 cm×9.0 cm. The flap was designed along edge of the defect. Two proximal triangular flap were separated, and sutured in contraposition. The rest of the flap was advanced to cover the defect. Results The postoperative follow-up period ranged from 2 months to 20 months (median time of 9 months). All flap survived without necrosis. Hematoma occurred in 2 patients, were healed after debridement. All patients were satisfied with the aesthetic and functional outcomes. Conclusions The technique of Pacman flap is a simple and effective method to repair the skin and soft tissue defects.