腹直肌肌皮瓣在胸部缺损修复中的应用

Application of Rectus Abdominis Myocutaneous Flap in the Repair of Chest Defects

目的:探讨腹直肌肌皮瓣在胸部缺损修复中的应用效果。方法:选取笔者科室2015年5月-2018年12月的8例患者,乳腺癌术后乳房缺损2例,放射性溃疡合并乳房缺损3例,胸骨骨髓炎患者3例。其中5例采用纵行腹直肌肌皮瓣;3例采用横行腹直肌肌皮瓣修复,供瓣区给予缝合修复。结果:8例患者腹直肌肌皮瓣均成活良好,创面痊愈,其中5例乳房重建患者效果满意。术后随访1~3年,溃疡无复发,供瓣区无腹壁疝形成。结论:腹直肌肌皮瓣血运可靠、组织量充足,是修复胸壁溃疡及女性乳房重建的理想选择,是一种有效、简单和安全的方法。

Objective To discuss the application of rectus abdominis myocutaneous flap in chest ulcer and breast reconstruction.Methods Eight patients from the author's department from May 2015 to December 2018 were selected,two cases of breast defect after operation of breast cancer,three cases of radiation ulcer with breast defect,three cases of sternal osteomyelitis.Five cases underwent longitudinal rectus abdominis myocutaneous flap,three cases were repaired with transverse rectus abdominis myocutaneous flap,the donor flap was repaired by suture.Results Eight cases of rectus abdominis myocutaneous flap survived well,the wound healed,the results of breast reconstruction were satisfactory in five cases.The postoperative follow-up was 1-3 years,and there was no recurrence of ulcer,there was no abdominal hernia in the donor area.Conclusion Rectus abdominis myocutaneous flap has reliable blood supply and sufficient tissue.It’s an good ideal for repairing chest wall ulcers and breast reconstruction in women.It is an effective,simple and safe method.