预扩张斜方肌肌皮瓣在儿童面颈胸部烧伤后瘢痕修复中的应用  

Application of prefabricated expanded trapezius myocutaneous flap in faciocervical and thoracic burn scar repair in children

作　　者：闫利[1] 王毅铮[2,3] 姜孟臣[1] 刘洪琪[1] 

机构地区：[1]中国人民武装警察部队医学院附属医院烧伤整形中心,天津300162 [2]中国人民武装警察部队医学院军队卫生学教研室 [3]天津市职业与环境危害生物标志物重点实验室

出　　处：《中国急救复苏与灾害医学杂志》2010年第5期428-430,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨预扩张技术联合斜方肌肌皮瓣修复儿童面颈胸部烧伤后瘢痕的手术可行性及效果。方法15例面颈胸部烧伤后瘢痕形成的患儿，在斜方肌部位设计供瓣区1～3个50-600ml容积的皮肤软组织扩张器，扩展预计容积，取出扩张器，以颈横动脉为血管蒂，比照瘢痕切除后所继发的创面及转移长度、扭转角度，切取斜方肌肌皮瓣修复创面，供瓣区直接拉拢缝合。结果14例手术成功，预期皮瓣大小（16．7±6．2）cm×（8．8±5．2）cm。1例术后皮瓣淤血后感染。供瓣区伤口愈合良好，成活皮瓣较瘢痕与邻近部位皮肤色泽、质地与缺损区组织更近似。结论预扩张斜方肌肌皮瓣适合于儿童面颈胸部烧伤后瘢痕的修复，术后效果理想。Objective To explore the feasibility and effect of the operation of repairing faciocervical and thoracic burn scar by prefabricated expanded trapezius myocutaneous flap in children. Methods 1- 3 skin soft-tissue expanders with the volume of 50-600 ml were implanted in the trapezius muscle at the planned flap-offering region of 15 children with faciocervical and thoracic burn scar so as to expand the skin soft-tissue expanders to the projected volume, and took out the expanders. The transverse cervical artery was used as vascular pedicle, contrasted with the secondary wound after cieatrectomy, transfer length, and turning angle. The trapezius myocutaneous flap was cut to cover the wound, and the wound at the flap-offering region underwent transfixation suture. Results The operation succeeded in 14 ease. The sizes of the expected flaps were （16.7±6.2） crux（8.8 ±5.2） cm. Congestion and infection of the flap were found in 1 case. The wound of the flap area was healed. The skin color and the texture of the survived flaps were much closer to those of the scar. Conclusion Prefabricated expanded trapezius myoeutaneous flap is suitable to faciocervical and thoracic burn scar repair, with a good postoperative effect in children.

关 键 词：皮肤软组织扩张术 斜方肌肌皮瓣 面颈胸部烧伤瘢痕 儿童 

分 类 号：R62[医药卫生—整形外科]