胸廓内动脉穿支皮瓣联合浅层X线治疗女性胸部瘢痕疙瘩疗效评价

Efficacy of internal mammary artery perforator flap combined with superficial X-ray radiotherapy for anterior chest wall keloid in female patients

目的:探讨胸廓内动脉穿支(internal mammary artery perforator,IMAP)皮瓣联合术后浅层X线治疗女性患者胸部瘢痕疙瘩的疗效。方法:回顾性分析2022年12月至2024年1月我院收治的创面修复采用IMAP皮瓣,术后联合浅层X线治疗的8例女性胸部瘢痕疙瘩患者资料。结果:8例患者中合并窦道、感染4例,局部破溃2例,瘢痕疙瘩范围3.5 cm×5 cm~11 cm×5 cm。所有患者术后IMAP皮瓣均成活良好,术后胸部功能、乳房形态均较满意。随访期间,供受区无瘢痕增生复发,未见放射相关癌变,牵拉、疼痛、瘙痒症状明显缓解。结论:采用IMAP皮瓣联合浅层X线治疗女性胸部瘢痕疙瘩,可有效降低术区张力,获得较好的胸部功能及乳房形态。

Objective:To assess the efficacy of internal mammary artery perforator(IMAP)flap combined with superficial X-ray radiotherapy for anterior chest wall keloid in female patients.Methods:The data of eight female patients with chest keloid treated with IMAP flap combined with superficial X-ray radiotherapy after operation in our hospital from December 2022 to January 2024 were analyzed retrospectively.Results:Of 8 patients,four had sinus and two had ulceration.The size of keloid ranged from 3.5 cm×5 cm to 11 cm×5 cm.All IMAP flaps survived well.The patients were satisfied with the breast shape and symmetry after operation.During the follow-up period,no scar hyperplasia recurred and radiation-related carcinogenesis were observed.The symptoms of pulling,pain and itching were significantly relieved.Conclusions:IMAP flap repair combined with superficial X-ray radiotherapy can effectively reduce the tension of the operative area,and which can preserve the good breast shape.