摘要
目的探讨应用岛状背阔肌肌皮瓣或穿支皮瓣修复上臂内侧皮瓣供区缺损的可行性和技术要点。方法自2015年12月至2019年6月,应用预扩张上臂内侧皮瓣修复头颈部皮肤软组织缺损,同期应用岛状背阔肌肌皮瓣或胸背动脉穿支皮瓣带蒂转移修复上臂供区缺损11例。采用近端蒂上臂内侧皮瓣修复3例,远端蒂上臂内侧皮瓣修复8例。术中切除病变组织后遗留缺损面积为12 cm×7 cm^15 cm×11 cm。预扩张上臂内侧皮瓣面积为18 cm×8 cm^27 cm×14 cm;背部组织瓣切取面积为16 cm×7 cm^22 cm×10 cm。所有供区直接拉拢缝合。结果所有皮瓣均成活,受区及供区均一期愈合,无手术相关并发症发生。随访1~18个月,转移皮瓣的颜色、质地和厚度均与受区皮肤相似,患者对头面部、上臂内侧和背部供瓣区的美学形态均较满意。结论在应用上臂内侧皮瓣修复头颈部较大面积皮肤软组织缺损时,可同期切取一个岛状背阔肌肌皮瓣或胸背动脉穿支皮瓣修复上臂内侧皮瓣供区缺损,既能保证足够的组织量,又能确保供区的美学修复,从而达到较好的修复效果。
Objective To explore the feasibility and technical tips of island latissimus dorsal myocuatneous flap or perforator flap in the repair of donor-site defects of the medial upper arm flap.Methods Between December 2015 and June 2019,skin and soft tissue defects of the head and neck was repaired by pre-expanded medial upper arm flap.Eleven patients underwent the repair of donor-site defects of upper arm by either island latissimus dorsi myocutaneous flap or thoracodorsal artery perforator flap at the same time.Three patients were repaired by proximal pedicle medial upper arm flap and 8 patients were repaired by distal pedicle medial upper arm flap.The area of defects after lesion tissues resection ranged from 12 cm×7 cm to 15 cm×11 cm.The area of pre-expanded medial upper arm flap ranged from 18 cm×8 cm to 27 cm×14 cm.The incised area of back tissue flap ranged from 16 cm×7 cm to 22 cm×10 cm.All donor sites were directly sutured.Results All flaps were survived.All recipient and donor sites were healed by first intention.No surgery-related complications were occurred.All patients were followed up from 1 to 18 months,the color,texture and thickness of transfer flap was similar to the skin of recipient site.All patients were satisfied with the aesthetic morphology of face,neck and donor site of medial upper arm and back.Conclusion In the repair of large area skin and soft tissue defects on the head and neck by medial upper arm flap,either an island latissimus dorsi myocutaneous flap or a thoracodorsal artery perforator flap could be simultaneously harvested and used to repair the donor-site defects of medial upper arm flap.Both sufficient tissue and aesthetic repair of donor site could be ensured.Good repair efficacy could be attained.
作者
汪淼
刘元波
朱珊
臧梦青
陈博
李杉珊
韩婷璐
WANG Miao;LIU Yuan-bo;ZHU Shan;ZANG Meng-qing;CHEN Bo;LI Shan-shan;HAN Ting-lu(Department of Plastic and Re-constructive Surgery,Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical School,Beijing 100144,China)
出处
《中国美容整形外科杂志》
CAS
2020年第7期396-399,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
上臂内侧皮瓣
供区缺损修复
岛状背阔肌肌皮瓣
胸背动脉穿支皮瓣
Medial upper arm flap
Repair of donor-site defects
Island latissimus dorsi myocutaneous flap
Thoracodorsal artery perforator flap
