改良背阔肌肌皮瓣游离修复软组织缺损的临床应用  

Clinical application of the latissimus dorsi musculocutaneous flap with a few muscle in repairing the larger limbs defect

作　　者：盛辉[1] 田恒进[1] 靖树林[1] 王志勇[1] 张治家[1] 李德保[1] 

机构地区：[1]泰兴市人民医院整形外科,江苏泰兴225400

出　　处：《中国美容整形外科杂志》2014年第11期651-653,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的：探讨应用胸背动脉外侧支供血的改良背阔肌肌皮瓣移植修复软组织缺损创面的临床效果。方法对7例软组织缺损的患者采用胸背动脉外侧支供血改良背阔肌肌皮瓣进行移植修复。利用胸背血管的外侧支供血带少许肌袖,皮瓣解剖时保留胸背神经的主干及内侧支,皮瓣面积15.0cm×8.0cm-22.0cm×12.0cm。结果7例皮瓣完全成活,1例胫前软组织缺损的患者术后2h出现血管危象,经探查重新吻合静脉,创口Ⅰ期愈合。背部供区植皮创面4例Ⅰ期愈合,3例边缘部分皮片坏死,经换药治愈。对所有患者随访3-12个月,皮瓣外形与功能均较满意。结论利用胸背动脉外侧支供血改良背阔肌肌皮瓣移植修复软组织缺损是较为理想的方法,临床上值得推广应用。Objective To explore the anatomy basis and clinical effect of the latissimus dorsi musculo-cutaneous flap with a few muscle.Methods Based on anatomical study,the latissimus dorsi musculocuta-neous flap with a few muscle was designed and transferred to reconstruct 1 cases of the calcar pedis′s soft tissue defect,2 cases of the dorsum pedis′s soft tissue defect,2 cases of the anticnemion′s soft tissue defect,1 case of the whole scalp avulsion injury with large skull exposure.Among these flaps,7 flaps were designed to perforator flap with a few muscle,1 flap was reserving partly thoracodorsal nerve.The flap area ranged from 1 5.0 cm×8.0 cm to 22.0 cm×12.0 cm.Results 7 flaps survived completely,follow-up was performed for 3 to 12 months,the appearance and color of the flaps were satisfaction.Conclusion This kind of the flap has reliable blood supply and could be operated conveniently and safely.It is an ideal method to repair the larger limbs soft-tissue defect.

关 键 词：背阔肌肌皮瓣 软组织缺损 显微外科 胸背神经 肌皮动脉 

分 类 号：R628[医药卫生—整形外科]