血管移植技术在面颈部组织扩张术中的临床应用  

Clinical application of a vasotransplantation technique in faciocervical soft tissue expansion

作　　者：刘元波[1] 范金才[1] 唐欣[1] 焦鹏[1] 刘立强[1] 王黔[1] 田佳 甘承[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院,北京100041

出　　处：《中国美容整形外科杂志》2007年第3期208-210,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的将血管移植皮瓣预制技术应用于常规的面颈部组织扩张术中,从而提高扩张皮瓣转移的灵活性和利用率。方法手术分两期进行:Ⅰ期手术,以颞浅动静脉为蒂,掀起颞浅筋膜瓣,同时,在面颈部剥离,形成适当大小的组织腔隙,将颞浅筋膜瓣转移至组织腔隙内,适当固定,在筋膜瓣下放置皮肤扩张器;Ⅱ期手术,扩张完毕后,取出扩张器,以颞浅动静脉为蒂,将传统的面颈部扩张皮瓣,转化为可以带蒂转移的岛状皮瓣,用于颜面部组织缺损的修复。结果临床应用11例,分别用于面部黑痣、血管瘤和面部瘢痕切除后遗留创面的修复。颞浅筋膜岛状瓣血管蒂长6.5~10.0cm,筋膜瓣面积5.0cm×5.0cm^6.0cm×8.0cm,面颈部扩张岛状皮瓣的面积为6.0cm×8.0cm^7.0cm×17.0cm。术后皮瓣全部成活,供瓣区直接拉拢缝合者7例,另行植皮修复者4例。结论血管移植技术和常规皮肤软组织扩张技术相结合,可以将传统的扩张皮瓣转化为可以带蒂转移的岛状皮瓣,提高了扩张皮瓣转移时的灵活性和皮瓣的利用率。Objective To apply the techniques of vasotransplantation to conventional ratio- cervical soft tissue expansion so as to improve the flexibility of the transfer of the expanded skin flap and its utilization ratio. Methods The procedure was divided into two stages. In the first stage, the superficial temporal fasdal flap was elevated, pedicled on superficial temporal vessels. Meanwhile, an appropriate subcutaneous tissue pocket was made after dissection in the facioocerical region, and then the fascial flap was transferred into the pocket and fixed properly. The tissue expander was placed under the fascial flap. The expander was removed after the expanding and the expanded prefabricated skin flap on the faciocervical region pedided on superficial temporal vessels was elevated and transferred to repair the facial skin defects.Results Prefabricated expanded induced skin flaps were used to repair facial defects in 11 cases, which resulted from the excisions of melanotic nevus, hemangioma and facial scare. The length of the vascular pedicle of the superficial temporal fascial flaps ranged from 6.5cm to 10.0cm. The size of the fascial flaps ranged from 5.0 cm×5.0 cm to 6.0 cm× 8.0 cm. The size of the expanded island skin flaps was raged from 6.0cm×8.0cm to 7.0cm×17.0cm. All flaps survived postoperatively. The donor sites in 7 cases were sutured directly. Split-thickness skin grafting was used to close the doner sites in the other 4 cases. Conclusion The traditional expanded skin flap can be converted to an island skin flap with a combination of the techniques of vasotransplantation and routine soft tissue expansion. The flexibility of flap transfer and the utilization rate of the flap can be improved through the techniques mentioned which represent refinement and modification of the traditional skin and soft tissue expansion techniques.

关 键 词：预制皮瓣 颞浅筋膜 血管移植 组织扩张 

分 类 号：R622[医药卫生—整形外科]