携带小穿支皮瓣的背阔肌肌瓣移植与钛网联合应用修复巨大头皮、颅骨双重缺损  

Repair of huge scalp and skull defect with latissimus dorsi muscle with small perforator flap and titanium mesh

作　　者：陈福东 李林[2] 吴敏[3] 郑国寿[4] 王海平[3] 

机构地区：[1]株林镇达城卫生院外科,湖北蕲春435300 [2]松滋市人民医院外科 [3]华中科技大学同济医学院附属同济医院整形美容外科 [4]华中科技大学同济医学院附属同济医院创伤外科

出　　处：《中国美容整形外科杂志》2015年第1期37-39,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：基金项目：湖北省自然科学基金资助（2008CDB190）

摘　　要：目的 探讨携带小穿支皮瓣的背阔肌肌瓣移植与钛网联合应用,修复巨大头皮、颅骨缺损的方法和临床效果.方法 自2011年6月至2013年1月,对7例巨大头皮并颅骨缺损的患者,采用携带小穿支皮瓣的游离背阔肌肌瓣移植加钛网进行修复,并对其术后外形及功能进行评价.结果 7例背阔肌肌瓣全部存活,供区瘢痕隐蔽;钛网固定及支撑牢固,未出现钛网外露、排异反应、慢性疼痛等并发症;覆盖钛网的软组织温暖柔软、颜色质地良好.结论 钛网轻薄有强度,组织相容性好,易于塑形,可以恢复颅骨外形及强度;小的穿支皮瓣血供可靠,游离背阔肌肌瓣可提供大面积血供丰富的组织,为钛网提供良好的组织覆盖,同时能减少植入物外露等并发症发生.二者联合应用,是修复巨大头皮、颅骨缺损较理想的方法.Objective To investigate the method and effect of Latissimus dorsi muscle with small perforator flap and Titanium mesh in the treatment of scalp and skull defect. Methods During the period of June of 2011 to January of 2013, 7 patients diagnosed with large scalp and skull defect were treated with latissimus dorsi muscle with small perforator flap transfer and titanium mesh. Postoperative outcomes were evaluated. Resuits All 7 flaps survived with concealed scar in donor site, fast support by titanium mesh fixation and without titanium mesh exposure, rejection and chronic pain. The soft tissue covering the titanium mesh was warm and soft with good texture. Conclusion Titanium mesh was thin and easily reshaped, hard enough to support and compatible to the tissues. Free lartissimus dorsi muscular flap afforded robust blood supply and sufficient tissue to cover the hardware with desirable outcome. Combination of lartissimus dorsi muscle with small perforator flap and Titanium mesh afforded a good choice for large scalp and skull defect.

关 键 词：头皮颅骨缺损 背阔肌肌瓣 穿支皮瓣 钛网修复 

分 类 号：R651.1[医药卫生—外科学] R622[医药卫生—临床医学]