背部带蒂轴型肌皮瓣修复邻近部位深度创面22例  

Repair of adjacent deep wound using pedicled axial myocutaneous flap from the posterior trunk

作　　者：张丕红[1] 黄晓元[1] 肖目张[1] 任利成[1] 张明华[1] 龙剑虹[1] 范鹏举[1] 曾纪章[1] 谢庭鸿[1] 

机构地区：[1]中南大学湘雅医院烧伤整形外科,长沙410008

出　　处：《中华损伤与修复杂志（电子版）》2010年第4期20-22,共3页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨带蒂轴型背部肌皮瓣在邻近部位深度创面修复中的应用。方法 2005年至2010年中南大学湘雅医院烧伤整形外科采用轴型背部肌皮瓣转移修复邻近部位深度创面22例。烧(创)伤创面彻底清创、溃疡和肿瘤切除后采用胸背动脉为蒂的背阔肌肌皮瓣14例,背阔肌肌皮瓣联合髂腰皮瓣3例,联合胸大肌皮瓣1例,腰动脉和肋间后血管为蒂的逆行背阔肌肌皮瓣1例,下位斜方肌肌皮瓣3例。结果背阔肌肌皮瓣转移术后感染或远端部分坏死各1例;4例供瓣区植皮部分未成活,经再次扩创或二期植皮后愈合。其余组织瓣移植未见并发症发生。随访3～24月,修复部位功能和外观均基本满意。结论带蒂轴型背部肌皮瓣能满足颈、胸、上肢等深度创面覆盖的需要,可安全、有效地修复这些部位的深度创面。Objective To explore the application of pedicled axial myocutaneous flap from the posterior trunks repairing their adjacent deep wounds. Methods From 2005 to 2010, 22 pedieled axial myocutaneous flaps from the posterior trunk were used to repair their adjacent deep wounds. These defects were repaired with 18 latissimus dorsi museuloeutaneous flaps pedicle with thoracodorsal artery （one combined with peetoralis major museulocutaneous flap, and 3 combined with iliolumbar skin flap）, one latissimus dorsi museulocutaneous flap pedicle with the posterior branches of posterior intercostal arteries and lumbar arteries, and three lower trapezius museulocutaneous flaps respectively after debridement and resection of ulcer or tumor. Results Wound infection and partial necrosis occurred in one ease each. The wound achieved primary healing except re-debridement on one infected flap mentioned above and second-stage skin grafting on 4 donor sites and one partial necrotic flap. After a follow-up of 3 to 24 months, the function and configuration were appropriately satisfactory. Conclusion The transplantation of pedicled myocutaneous flaps from the posterior trunk would be safe, effective and reliable in the management of patients with deep wounds in the neck, chest and upper extrimity.

关 键 词：外科皮瓣 烧伤 修复外科手术 软组织缺损 

分 类 号：R644[医药卫生—外科学]