扩张后皮瓣修复腋前皱襞瘢痕挛缩  

Repair of cicatricial contracture in plica axillaris anterior with expanded flap

作　　者：马显杰[1] 李威扬[1] 董立维[1] 简彩[1] 王璐[1] 刘恒鑫[1] 

机构地区：[1]第四军医大学西京医院全军整形外科研究所,陕西西安710032

出　　处：《中国美容整形外科杂志》2013年第5期286-287,共2页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：国家自然科学基金资助项目（81171826）;陕西省科学技术研究发展计划项目（2012SF2-01-2）

摘　　要：目的探讨腋部瘢痕挛缩的修复方法。方法先在邻近腋部的侧胸皮瓣或背阔肌皮瓣下置入扩张囊。扩张Ⅰ期，手术切口选择在侧胸部，将扩张器置入预扩张皮瓣下；经充分扩张后，先将腋部瘢痕彻底切除、松解，依创面大小设计扩张后皮瓣。皮瓣应较创面扩大10％～15％，并使旋转点至创面的距离应小于到皮瓣的距离，供区拉拢缝合。结果本组共6例患者，术后皮瓣完全成活，腋部活动无受限，效果满意。结论扩张后的侧胸皮瓣或背阔肌皮瓣是修复腋部较大面积瘢痕切除后创面的较好选择。Objective To investigate the preparing method of cicatricial contracture in plica axillaris ante- rior. Methods The soft tissue expander was implanted under the skin flaps nearby the axilla underneath lateral thorax or latissimus dorsi muscle. At the first stage of expansion, the incision was designed at lateral chest wall ; the expander was implanted into pre-expanded skin. After full expansion, axillary scar was excised completely and loosened. According to defects, the expanded flaps were designed 10% to 15% larger than the defects, and then the flaps were harvested. The distance from pedicle to the defect was also larger than the distance between pedicle and flap. The donor site was closed with suture. Results Theexpanded flaps in 6 cases were survival completely. All cases were satisfied without limitation of axillary activity. Conclusion Expanded skin flaps of lateral thorax or latissimus dorsi muscle are ideal flaps in treatment of extensive axillary cicatricial contracture.

关 键 词：腋部 瘢痕 扩张术 轴型皮瓣 

分 类 号：R619.6[医药卫生—外科学]