改良术式的扩张后颈横动脉分支皮瓣在修复面颈部挛缩瘢痕的应用经验  

Application of modified expanded cutaneous branch flap pedicled by cervical transverse artery in treatment of faciocervical cicatricial contracture

作　　者：秦王驰[1] 梁智[1] 杨卫国[1] 林海波[1] 郭正东[1] 刘飞[1] QIN Wangchi;LIANG Zhi;YANG Weiguo;LIN Haibo;GUO Zhengdong;LIU Fei(Plastic Surgery,Nanshan People??s Hospital,Shenzhen,Guangdong 518067,China)

机构地区：[1]深圳市南山区人民医院整形美容烧伤科,广东深圳518067

出　　处：《岭南现代临床外科》2019年第2期228-230,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的通过改进传统的扩张后颈横动脉分支皮瓣手术方式,进一步改善该皮瓣修复面颈部挛缩瘢痕的术后疗效。方法从2014年2月到2018年10月,9例面颈部瘢痕挛缩的病人在我院接受该手术治疗。在传统的一期放置皮瓣下扩张器、和二期皮瓣转位的基础上,进行皮瓣周缘非轴行血管蒂的皮支埋线结扎、及转位术前1周行皮瓣延迟术。结果皮瓣转位后无1例出现血运障碍,皮瓣在受区顺利存活,无愈合不良的现象出现,各项外观指标患者满意,供区直接拉拢缝合,术后效果良好。结论通过皮支埋线结扎及转位前皮瓣延迟术,可明显改善皮瓣术后生存率及术后疗效。Objective To improve the effects of treatment of faciocervical cicatricial contracture by a modified expanded cutaneous flap pedicled by cervical transverse artery. Methods Nine cases with faciocervical cicatricial contracture received flap transfer from Feb 2014 to Oct 2018. Besides routine imbedment of soft tissue expander,we applied buried stitches to block cutaneous branches from thoracoacromial and internal thoracic vessels firstly. Secondly,the delay procedure was used before one week of flap transfer. Results There was no surgical complications existed postoperatively including necrosis,circulation disturbance and infection. The texture of receipt area was similar with surrounding skin and faciocervical appearance was improved obviously. Donor site could be closed firstly and no need for free skin graft. Conclusion The survival rate and postoperative effect of cutaneous branch flap pedicled by cervical transverse artery can be notably improved by some modifications including buried stitches and delay procedure.

关 键 词：颈横动脉分支皮瓣 预扩张 

分 类 号：R654.3[医药卫生—外科学]