摘要
目的探讨利用游离背阔肌肌皮瓣修复头部复合组织缺损创面的临床效果。方法2015年7月至2018年4月玉林市第一人民医院收治各种原因导致的头部复合组织缺损创面患者7例,男5例,女2例,年龄10~52岁,头部鳞癌5例,电击伤1例,外伤1例。对于肿瘤患者联合神经外科对病灶组织进行切除,外伤患者彻底扩创后立即切取背阔肌肌皮瓣游离移植覆盖创面,供区移植皮片或直接拉拢缝合。结果背阔肌肌皮瓣切取面积16 cm×6 cm^28 cm×20 cm,胸背动、静脉与颞浅动、静脉顶支吻合6例,胸背动、静脉与枕动静、脉吻合1例。术后6例肌皮瓣血运良好,1例于术后次日出现静脉危象,探查桥接静脉,抢救成活,所有创面均获得较好的修复。术后随访3个月至1年,肿瘤患者未见肿瘤复发,创面局部平整。结论背阔肌肌皮瓣组织量丰富,充填修复能力强,是修复头部复合组织缺损创面的较好方法。
Objective To explore the clinical effect of free latissimus dorsi myocutaneous flap in the repair of head composite tissue defect.Methods From July 2015 to April 2018,7 patients with head composite tissue defect,which included 5 males and 2 females,aged from 10 to 52 years old were admitted in the First People′s Hospital of Yulin.The wounds were caused by various reasons 5 cases of head squamous cell carcinoma,1 case of electric injury and 1 case of trauma.For tumor patients combined with neurosurgery to remove the lesion tissue,the latissimus dorsi myocutaneous flap were cut and transplanted to cover the wound immediately after the thorough expansion of trauma patients,and the donor area were closed directly or byskin grafts.Results The latissimus dorsi musculocutaneous flaps were cut with areas from 16 cm×6 cm to 28 cm×20 cm,6 cases of thoracic and dorsal vessels anastomos is with the superficial temporal vessels,and 1 case of thoracic and dorsal vessels anastomosis with occipital vessels.The blood supply of myocutaneous flaps were good in 6 cases,and venous crisis occurred in 1 case on the second day after the operation.Postoperative follow-up was conducted for 3 months to 1 year.No tumor recurrence was observed in the tumor patients,and the wound surfaces were locally smooth.Conclusions The latissimus dorsi musculocutaneous flap is a good method for repairing the defect of the head composite tissue defect with big size and good blood supply.
作者
杨力
薛君荣
蒋鹏
郭贤钊
Yang Li;Xue Junrong;Jiang Peng;Guo Xianzhao(Department of Burn and Plastic Surgery,the First People′s Hospital of Yu Lin in Guang Xi,Yulin 537000,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2019年第10期991-994,共4页
Chinese Journal of Plastic Surgery
关键词
外科皮瓣
背阔肌肌皮瓣
皮瓣游离移植
头部
复合组织
创面
Surgical flap
Latissimus dorsi myocutaneous flap
Free flap transplantation
Head
Compound tissue
Wound
