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延迟术在胸三角皮瓣预扩张修复面部大面积瘢痕中的应用

The application of deltopectoral flaps with delayed expansion in repairing large scars on face

摘要:

目的 了解延迟术在预扩张胸三角皮瓣修复面部大面积瘢痕中的应用效果.方法 笔者单位在预扩张胸三角皮瓣转移术中应用延迟术,修复13例患者面部大面积瘢痕.于患者扩张器置入同期切断胸肩峰动脉皮支及颈横动脉颈段皮支,使扩张的胸三角皮瓣血运以胸廓内动脉第2、3肋间穿支为主,起到了延迟作用.观察皮瓣血管网的分布和皮瓣血运状态,了解延迟的效果.结果 扩张皮瓣血管网明显增多、增粗,延迟后转移的皮瓣远端无血运障碍.术后随访4~18个月,13例患者脸部移植部位轮廓与对侧基本协调,无臃肿感.皮瓣色泽与面部正常皮肤相近,柔软度好.结论 应用延迟术可以更好地保证胸三角皮瓣在转移后的血运,此法修复面部大面积瘢痕效果较好.

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Objective To evaluate the effect of use of deltopectoral flaps with delayed expansion in repairing large scar on face. Methods Thirteen patients with large scars on face received above-men-tioned surgery. The cutaneous branches of thoraeoaeromial artery and transverse cervical artery of patients were divided when the expander was implanted. As a result, the blood supply of expanded deltopectoral flaps principally depended on the second and third intercostal branches of internal thoracic artery, and a delaying effect was achieved. The distribution of vascular net in the flap and the state of blood supply of the flap were observed to evaluate the effect of delaying. Results The vascular net of expanded flap increased and thickened. No blood supply disorder occurred at the distal end of the transferred flap. Patients were followed up for 4 to 18 months. The outline of the burn side of face was in accord with the opposite side, which was not fat and clumsy. The complexion of the flap was similar to that of normal skin of the face, and the flap was soft in texture. Conclusions The application of delaying can better ensure the blood supply of trans-ferred deltopectoral flap. The result of applying delayed expansion of deltopectoral flaps in repairing large scars on face was good.

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