摘要
目的:探讨颈横动脉颈段皮支岛状瓣对烧伤晚期重度颈部瘢痕挛缩畸形治疗的临床应用。方法:对17例重度颈部瘢痕挛缩畸形患者全部采用颈横动脉颈段皮支岛状瓣修复。供瓣区采用游离皮片覆盖。结果:术后皮瓣全部成活,蒂部平整,无猫耳形成,颈部外形及功能恢复良好。2例供瓣区所植皮片因皮下血运不良而部分坏死,经换药处置后愈合。结论:对于轻、中度颈部瘢痕挛缩畸形的病例,采用颈、胸随意皮瓣,胸三角皮瓣即可得到较满意的效果。而对于重度颈部瘢痕挛缩畸形的病例,因瘢痕多累及颈前、颈侧、颏部及前胸,而限制了颈胸皮瓣,胸三角皮瓣等随意皮瓣及轴形瓣的应用,且游离皮片容易继发挛缩,加重畸形。颈横动脉段皮支岛状瓣的应用则避免了上述治疗的不足,是一种治疗重度瘢痕畸形的好方法。
Objective： To discuss the chnical treatment of severe cervical cicatricial contracture malformation in late burn with the insular skin flap of the cutaneous branch of cervical part of transverse cervicel artery. Methods： Applying the insular skin flap of the cutaneous branch of cervical of transverse cervical artery to repair the severe cervical cicatricial contracture malformation in all 17cases.We used the transplantion of free skin graft to cover the area which provided the skin flap.Results： After operation all the skin flaps survived well,the pedicles looked smooth and tidy,no catear formed.The appearance and function of cervical restored well.Partial necrosis of skin flap in 2 cases occurred due to poor subcutaneous blood circulation and was cured via dressing change. Conclusion： For the cases of mild, moderate cicatricial contracture malformation,we acquired the better effect with applying neck-thorax voluntary skin flap and thorax triangle skin flap.For the severe cervical cicatricial contracture malformation cases,because the scar often involved in the front part and lateral part of neck,chin and prothorax,so this restricted the application of the voluntary and axial skin flap, such as neck-thorax skin flap, thorax triangle skin flap,and the free skin flap was subject to secondary contracture,such as severe malformation.The apphcation of insular skin flap of the cutaneous branch of cervicalof transverse cervical artery might avoid the deficiency of above methods and the best treatment for severe cervical cicatricial contracture malformation.
出处
《中国伤残医学》
2011年第6期3-4,共2页
Chinese Journal of Trauma and Disability Medicine
关键词
颈部瘢痕
外科皮瓣
颈横动脉
Cervical scar
Surgical Flaps
Transverse cervical artery
