<strong>Objective:</strong> To explore the methods and effects of pectoralis major myocutaneous flap in pharyngolaryngeal cancer surgery. <strong>Methods:</strong> Among 23 cases of pharyngolar...<strong>Objective:</strong> To explore the methods and effects of pectoralis major myocutaneous flap in pharyngolaryngeal cancer surgery. <strong>Methods:</strong> Among 23 cases of pharyngolaryngeal cancer patients, the surgical procedure was based on pathologic conditions, and the surgical defects were repaired by pectoralis major myocutaneous flap. <strong>Results:</strong> Among 23 patients, there were 1 case of skin flap necrosis, 4 cases of pharyngeal fistula, 1 case of hypopharyngeal esophageal stenosis;except 1 case of pharyngeal fistula died of carotid artery rupture caused by infection, 1 case of hypopharyngeal esophageal stenosis required a gastric tube, and the rest patient’s swallowing function is normal. <strong>Conclusion:</strong> The blood supply of pectoralis major myocutaneous flap is reliable with the tissue volume enough for reconstruction. It turns out to improve patient survival and postoperative quality of life with the application of pharyngolaryngeal cancer surgery.展开更多
Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection(DSWI) following median sternotomy. Methods Between January ...Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection(DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males(73.7%) and 5 females(26.3%), aged 55±13(18-78) years. According to the Pairolero classification of infected median sternotomies, 3(15.8%) patients were type II, and the other 16(84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients(78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients(21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients(10.5%) presented with subcutaneous infection, and 3 patients(15.8%) had hematoma. They recovered following local debridement and medication. 17 patients(89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.展开更多
目的探讨胸大肌肌皮瓣(Pectoralis major myocutaneous flap,PMMF)修复面中部恶性肿瘤术后软组织缺损的临床效果。方法回顾性分析2018年1月-2020年6月治疗的面中部1/3皮肤或累及皮肤的恶性肿瘤11例,全部利用PMMF进行修复与重建术后软组...目的探讨胸大肌肌皮瓣(Pectoralis major myocutaneous flap,PMMF)修复面中部恶性肿瘤术后软组织缺损的临床效果。方法回顾性分析2018年1月-2020年6月治疗的面中部1/3皮肤或累及皮肤的恶性肿瘤11例,全部利用PMMF进行修复与重建术后软组织缺损,随访术后治疗效果。结果随访12~27个月,平均随访(20.5±5.5)个月,11例患者PMMF全部成活;部分患者经过术后放疗,局部未见明显异常改变;供区无明显并发症,患者对治疗结果满意。比较同一患者通过锁骨上及锁骨下通道血管蒂的长度,锁骨下通道能有效增加PMMF血管蒂的长度(P<0.01)。结论使用PMMF能够满足面中部恶性肿瘤患者术后修复软组织缺损的需求,是一种有效的修复方式。展开更多
文摘<strong>Objective:</strong> To explore the methods and effects of pectoralis major myocutaneous flap in pharyngolaryngeal cancer surgery. <strong>Methods:</strong> Among 23 cases of pharyngolaryngeal cancer patients, the surgical procedure was based on pathologic conditions, and the surgical defects were repaired by pectoralis major myocutaneous flap. <strong>Results:</strong> Among 23 patients, there were 1 case of skin flap necrosis, 4 cases of pharyngeal fistula, 1 case of hypopharyngeal esophageal stenosis;except 1 case of pharyngeal fistula died of carotid artery rupture caused by infection, 1 case of hypopharyngeal esophageal stenosis required a gastric tube, and the rest patient’s swallowing function is normal. <strong>Conclusion:</strong> The blood supply of pectoralis major myocutaneous flap is reliable with the tissue volume enough for reconstruction. It turns out to improve patient survival and postoperative quality of life with the application of pharyngolaryngeal cancer surgery.
文摘Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection(DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males(73.7%) and 5 females(26.3%), aged 55±13(18-78) years. According to the Pairolero classification of infected median sternotomies, 3(15.8%) patients were type II, and the other 16(84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients(78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients(21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients(10.5%) presented with subcutaneous infection, and 3 patients(15.8%) had hematoma. They recovered following local debridement and medication. 17 patients(89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.
文摘目的探讨胸大肌肌皮瓣(Pectoralis major myocutaneous flap,PMMF)修复面中部恶性肿瘤术后软组织缺损的临床效果。方法回顾性分析2018年1月-2020年6月治疗的面中部1/3皮肤或累及皮肤的恶性肿瘤11例,全部利用PMMF进行修复与重建术后软组织缺损,随访术后治疗效果。结果随访12~27个月,平均随访(20.5±5.5)个月,11例患者PMMF全部成活;部分患者经过术后放疗,局部未见明显异常改变;供区无明显并发症,患者对治疗结果满意。比较同一患者通过锁骨上及锁骨下通道血管蒂的长度,锁骨下通道能有效增加PMMF血管蒂的长度(P<0.01)。结论使用PMMF能够满足面中部恶性肿瘤患者术后修复软组织缺损的需求,是一种有效的修复方式。
