应用扩张肩胛皮瓣游离移植修复儿童肘窝瘢痕  

Using fabricated expanded scapular flap for free transplantation to repair the scar contracture in children's cubital fossa

作　　者：梁锋[1] 王海龙[1] 陈昴[1] 王爱武[1] 

机构地区：[1]陕西省汉中市中心医院美容整形科,723000

出　　处：《实用医药杂志》2016年第2期112-113,共2页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨预扩张肩胛皮瓣游离移植修复小儿肘窝瘢痕的可行性和手术技巧。方法手术分两期：Ⅰ期扩张器植入和皮肤扩张，在肩胛骨上缘上1～2cm横行做3cm左右切口，保护好旋肩胛动脉横支和降支穿出点掀起皮瓣．埋置合适的扩张器。术后10d开始注水过程，直到扩张组织达到受区要求。Ⅱ期先行肘窝瘢痕松解，解剖桡动静脉作为受区血管。切取相应大小皮瓣游离移植，吻合血管。皮瓣切取后供区创面直接缝合。结果本组6例患者，肩胛皮瓣扩张时间3～4个月不等，平均3．2个月；皮瓣大小（21～15）cm×（12～6）cm。术后皮瓣全部成活，供瓣区伤口愈合良好。结论预扩张肩胛皮瓣游离移植是一种不错的修复小儿肘窝瘢痕的方法。皮瓣扩张后组织量大，供瓣区容易直接缝合．扩张后皮瓣较薄，外形、功能均满意。Objective To investigate the feasibility and surgical techniques of free transplantation to repair the scar contracture in children cubital fossa using the fabricated expanded scapular flap. Methods The surgery included two stages：the first stage,3 cm level incision was made about 1-2 cm above the superior border of the scapular bone,with the transverse branch and descending branch of the scapular circumflex artery being carefully protected,then the selected tissue expander was implanted underneath the scapular flap. The expander was inflated until the expansion of the flap met the requirements of the repair;the second stage,the scar contracture in cubital fossa was excised and the radial artery and vein were dissected as recipient vessels,then the tissue expander was taken out and the scapular flap was harvested according to the size of the defects. The flap was free transplanted to the cubital fossa for anastomosis and the donor site was directly sutured. Results The above technique was used in 6 child patieats for 3 to 4 months （an averaged 3.2 months）. Flap size was （21-15）cmx（12-6）cm. All the flaps survived with the donor site healed without skin graft. Conclusion Free transplantation of the fabricated expanded scapular flap is a good method to repair the scar contracture in children＇s cubital fossa. The fabricated expanded flap has lager area which make it easierly to directly suture the donor site,and the thinner texture so that resulted in satisfactory appearance and function.

关 键 词：游离肩胛皮瓣 组织扩张术 肘窝瘢痕 

分 类 号：R622.1[医药卫生—整形外科]