背阔肌皮瓣移植在体表肿瘤切除后皮肤缺损中的应用

Application of Latissimus Dorsi Muscle Flap Transplantation in Skin Defect after Tumor Resection

目的探讨背阔肌皮瓣移植在体表肿瘤切除术后皮肤大面积缺损中的修复效果。方法选择2016年1月-2019年6月期间,在四川省人民医院整形外科进行体表肿瘤切除,术后大面积缺损的20例患者进行临床研究。其中男12例,女8例;背阔肌皮瓣一期移植14例、二期移植6例;年龄38~84岁;体表肿瘤扩大切除后形成的最大创面面积是18 cm×13 cm。所有患者均行背阔肌皮瓣移植修复,观察记录患者皮瓣移植成活率、移植并发症、移植后感觉功能恢复情况,评价临床疗效。结果20例皮瓣移植成活的有19例(皮瓣成活率95.00%);20例皮瓣移植出现1例(发生率5.00%)术后感染,经对症处理亦痊愈出院;19例成活的皮瓣移植区感觉及功能均恢复理想水平。患者术后住院平均康复时间为20.5 d,且术后随访期间无感染、溃疡等并发症发生。结论背阔肌皮瓣移植修复治疗体表肿瘤切除术后大面积皮肤缺损,创面愈合良好,移植成活率高,移植后皮肤区域功能感觉恢复良好,术后恢复时间较短。

Objective To investigate the repair effect of latissimus dorsi flap transplantation on large skin defect after resection of body surface tumor.Methods Twenty patients who underwent resection of body surface tumor in the Plastic Surgery Department of Sichuan Provincial People′s Hospital from January 2016 to June 2019 and had large skin defect after surgery were selected for clinical research.Among them,12 were males and 8 were females.There were 14 cases of first-stage latissimus dorsi flap transplantation and 6 cases of second stage.The age ranged from 38 to 84 years.The largest wound area formed after extended resection of body surface tumor was 18 cm×13 cm.All patients underwent latissimus dorsi flap transplantation and repair.The survival rate of flap transplantation,transplantation complications,and sensory function recovery after transplantation were observed and recorded before and after surgery to evaluate the clinical efficacy.Results Of the 20 patients with flap transplantation,19 survived(flap survival rate was 95.00%).Of the 20 cases of flap transplantation,one case(5.00%)had postoperative infection,and was discharged after symptomatic treatment.The sensation and function of 19 surviving flaps recovered to ideal level.The mean recovery time of the patients was 20.5 d,and no complications such as infection and ulcer occurred during the follow-up period.Conclusion In the treatment of large skin defect after resection of bodysurface tumor,latissimus dorsi myocutaneous flap transplantation leads to good wound healing,high transplantation survival rate,good recovery of skin function after transplantation,and shorter postoperative recovery.